Potential CT Findings to Improve Early Detection of Pancreatic Cancer.

Abstract

HomeRadiology: Imaging CancerVol. 4, No. 1 PreviousNext Research HighlightsFree AccessPotential CT Findings to Improve Early Detection of Pancreatic CancerAli PourvaziriAli PourvaziriAli PourvaziriPublished Online:Jan 21 2022https://doi.org/10.1148/rycan.229001MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Take-Away Points■ Major Focus: To assess early CT abnormalities of the pancreas in patients with subsequent pancreatic ductal adenocarcinoma (PDAC).■ Key Result: Up to 65% of patients with stage 1 PDAC demonstrated abnormalities at a CT scan performed 1 year prior.■ Impact: Subtle, nonsignificant abnormalities in the pancreas should raise suspicion for future PDAC and may suggest closer follow-up scans.PDAC is the most common pancreatic neoplasm, with a grim 5-year survival rate of 9%. Survival exceeds 80% in patients with tumors smaller than 1 cm, but early diagnosis remains an unmet clinical need. Attempts to discern reliable imaging features for early detection of PDAC have failed to date, due in part to inconsistent methods or flaws in design of prior studies.Toshima et al systematically reported CT imaging findings acquired at least 1 year before subsequent diagnosis of stage 1 PDAC in 103 patients compared to matched control CT scans. For both groups, they retrospectively and blindly evaluated the following predefined abnormalities: focal change in caliber of the main pancreatic duct, parenchymal atrophy or focal enhancement, cyst, or calcification. Focal atrophy was the earliest and most common abnormality, followed by faint focal enhancement and focal ductal changes. These abnormalities were present at 65% of CT scans performed 1 year earlier. Only presence of PDAC predicted focal abnormality of the pancreas by multivariate analysis.If validated prospectively, detection of these and potentially other imaging features could provide a pathway to early detection of grade 1 PDAC and improved patient outcomes.Highlighted ArticleToshima F, Watanabe R, Inoue D, et al. CT abnormalities of the pancreas associated with the subsequent diagnosis of clinical stage I pancreatic ductal adenocarcinoma more than 1 year later: a case-control study. AJR Am J Roentgenol 2021;217(6):1353–1364. doi: https://doi.org/10.2214/ajr.21.26014Highlighted ArticleToshima F, Watanabe R, Inoue D, et al. CT abnormalities of the pancreas associated with the subsequent diagnosis of clinical stage I pancreatic ductal adenocarcinoma more than 1 year later: a case-control study. AJR Am J Roentgenol 2021;217(6):1353–1364. doi: https://doi.org/10.2214/ajr.21.26014 Crossref, Medline, Google ScholarArticle HistoryPublished online: Jan 21 2022 FiguresReferencesRelatedDetailsRecommended Articles Chronic Pancreatitis or Pancreatic Tumor? A Problem-solving ApproachRadioGraphics2019Volume: 39Issue: 7pp. 1965-1982Pancreas in Hereditary Syndromes: Cross-sectional Imaging SpectrumRadioGraphics2021Volume: 41Issue: 4pp. 1082-1102Secretin-enhanced MR Imaging of the PancreasRadiology2016Volume: 279Issue: 1pp. 29-43“Biliary Diseases with Pancreatic Counterparts”: Cross-sectional Imaging FindingsRadioGraphics2016Volume: 36Issue: 2pp. 374-392Chronic Pancreatitis: Revisiting Imaging and the Values of Evidence-based Radiologic-Clinical CollaborationRadiology2018Volume: 290Issue: 1pp. 216-217See More RSNA Education Exhibits Missed Imaging Findings of Pancreatic Ductal Adenocarcinoma: Lessons Learned from Difficult Cases  Digital Posters2020Pancreas in Hereditary Syndromes: Cross-Sectional Imaging SpectrumDigital Posters2019Pancreatic Cystic Lesions: What Radiologists Should Know to Assess for MalignancyDigital Posters2020 RSNA Case Collection Intraductal Papillary Mucinous Neoplasm RSNA Case Collection2020Autoimmune PancreatitisRSNA Case Collection2021Autoimmune pancreatitis and cholangitisRSNA Case Collection2022 Vol. 4, No. 1 Metrics Altmetric Score PDF download