Prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case–control study

Hoogenboom, Sanne A.; Engels, Megan; Chuprin, Anthony; Hooft, Jeanin E. van; LeGout, Jordan D.; Wallace, Michael B.; Bolan, Candice W.

doi:10.1007/s00261-022-03671-6

Cited by 7 publications

(6 citation statements)

References 29 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, PM-SCLC does not easily cause the pancreatic duct to dilate, but rather pushes or compresses the pancreatic duct. In previous report (26,42), pancreatic duct dilatation could cause upstream parenchymal atrophy and this finding was observed in 5/34 patients (5%), and significantly less frequently in the group of PM-SCLC. Thus, absence of parenchymal atrophy was the discriminating features for the diagnosis of PM-SCLC against PDAC.…”

Section: Discussionmentioning

confidence: 69%

A nomogram diagnostic prediction model of pancreatic metastases of small cell lung carcinoma based on clinical characteristics, radiological features and biomarkers

Yang

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

ObjectiveTo investigate clinical characteristics, radiological features and biomarkers of pancreatic metastases of small cell lung carcinoma (PM-SCLC), and establish a convenient nomogram diagnostic predictive model to differentiate PM-SCLC from pancreatic ductal adenocarcinomas (PDAC) preoperatively.MethodsA total of 299 patients with meeting the criteria (PM-SCLC n=93; PDAC n=206) from January 2016 to March 2022 were retrospectively analyzed, including 249 patients from hospital 1 (training/internal validation cohort) and 50 patients from hospital 2 (external validation cohort). We searched for meaningful clinical characteristics, radiological features and biomarkers and determined the predictors through multivariable logistic regression analysis. Three models: clinical model, CT imaging model, and combined model, were developed for the diagnosis and prediction of PM-SCLC. Nomogram was constructed based on independent predictors. The receiver operating curve was undertaken to estimate the discrimination.ResultsSix independent predictors for PM-SCLC diagnosis in multivariate logistic regression analysis, including clinical symptoms, CA199, tumor size, parenchymal atrophy, vascular involvement and enhancement type. The nomogram diagnostic predictive model based on these six independent predictors showed the best performance, achieved the AUCs of the training cohort (n = 174), internal validation cohort (n = 75) and external validation cohort (n = 50) were 0.950 (95%CI, 0.917-0.976), 0.928 (95%CI, 0.873-0.971) and 0.976 (95%CI, 0.944-1.00) respectively. The model achieved 94.50% sensitivity, 83.20% specificity, 86.80% accuracy in the training cohort and 100.00% sensitivity, 80.40% specificity, 86.70% accuracy in the internal validation cohort and 100.00% sensitivity, 88.90% specificity, 87.50% accuracy in the external validation cohort.ConclusionWe proposed a noninvasive and convenient nomogram diagnostic predictive model based on clinical characteristics, radiological features and biomarkers to preoperatively differentiate PM-SCLC from PDAC.

show abstract

Section: Discussionmentioning

confidence: 69%

A nomogram diagnostic prediction model of pancreatic metastases of small cell lung carcinoma based on clinical characteristics, radiological features and biomarkers

Yang

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…The diagnostic yield (finding PDAC or high-grade dysplasia at resection) of surveillance-detected lesions is low (29% of those undergoing surgical resection, or 8.6% of high-risk individuals), despite expert multidisciplinary recommendation and shared decision-making. False-negative test results are also still a problem, and radiologists frequently (50%-62%) miss pancreatic cancers presenting with atypical or subtle signs on CT or MRI, which may lead to delayed diagnosis and advanced disease. In a retrospective review of prior negative MRI findings for carriers of germline CDKN2A pathogenic variants who developed PDAC, mild pancreatic ductal dilatation was an unrecognized subtle abnormality .…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Cancer Surveillance and Survival of High-Risk Individuals

Blackford,

Canto,

Dbouk

et al. 2024

JAMA Oncol

View full text Add to dashboard Cite

ImportancePancreatic ductal adenocarcinoma (PDAC) is a deadly disease with increasing incidence. The majority of PDACs are incurable at presentation, but population-based screening is not recommended. Surveillance of high-risk individuals for PDAC may lead to early detection, but the survival benefit is unproven.ObjectiveTo compare the survival of patients with surveillance-detected PDAC with US national data.Design, Setting, and ParticipantsThis comparative cohort study was conducted in multiple US academic medical centers participating in the Cancer of the Pancreas Screening program, which screens high-risk individuals with a familial or genetic predisposition for PDAC. The comparison cohort comprised patients with PDAC matched for age, sex, and year of diagnosis from the Surveillance, Epidemiology, and End Results (SEER) program. The Cancer of the Pancreas Screening program originated in 1998, and data collection was done through 2021. The data analysis was performed from April 29, 2022, through April 10, 2023.ExposuresEndoscopic ultrasonography or magnetic resonance imaging performed annually and standard-of-care surgical and/or oncologic treatment.Main Outcomes and MeasuresStage of PDAC at diagnosis, overall survival (OS), and PDAC mortality were compared using descriptive statistics and conditional logistic regression, Cox proportional hazards regression, and competing risk regression models. Sensitivity analyses and adjustment for lead-time bias were also conducted.ResultsA total of 26 high-risk individuals (mean [SD] age at diagnosis, 65.8 [9.5] years; 15 female [57.7%]) with PDAC were compared with 1504 SEER control patients with PDAC (mean [SD] age at diagnosis, 66.8 [7.9] years; 771 female [51.3%]). The median primary tumor diameter of the 26 high-risk individuals was smaller than in the control patients (2.5 [range, 0.6-5.0] vs 3.6 [range, 0.2-8.0] cm, respectively; P &lt; .001). The high-risk individuals were more likely to be diagnosed with a lower stage (stage I, 10 [38.5%]; stage II, 8 [30.8%]) than matched control patients (stage I, 155 [10.3%]; stage II, 377 [25.1%]; P &lt; .001). The PDAC mortality rate at 5 years was lower for high-risk individuals than control patients (43% vs 86%; hazard ratio, 3.58; 95% CI, 2.01-6.39; P &lt; .001), and high-risk individuals lived longer than matched control patients (median OS, 61.7 [range, 1.9-147.3] vs 8.0 [range, 1.0-131.0] months; 5-year OS rate, 50% [95% CI, 32%-80%] vs 9% [95% CI, 7%-11%]).Conclusions and RelevanceThese findings suggest that surveillance of high-risk individuals may lead to detection of smaller, lower-stage PDACs and improved survival.

show abstract

“…Imaging plays a crucial role in both the diagnosis and staging of PDAC. Initial diagnosis of a lesion must not be missed on the unexpected exam, such as imaging from the emergency room for nonspecific symptoms, as reported in 50–70% of cases in one study ( 4 ). Similarly, robust differentiation from other differential diagnoses is important in guiding management ( 5 ).…”

Section: Introductionmentioning

confidence: 85%

A narrative review of imaging for pancreas adenocarcinoma: staging, surgical considerations, and surveillance

Bolan,

Stauffer,

LeGout

et al. 2023

J Gastrointest Oncol

View full text Add to dashboard Cite

Background and Objective Pancreas adenocarcinoma is a disease with dire prognosis. Imaging is pivotal to the diagnosis, staging, reassessment, surgical planning, and surveillance of pancreas cancer. The purpose of this paper is to provide the reader an overview of current imaging practices for pancreas adenocarcinoma. Methods A literature search of original papers and reviews through 2022 was performed using the PubMed database. The most current American College of Radiology Appropriateness Criteria and National Comprehensive Cancer Network guidelines on pancreas cancer imaging were also included. Key Content and Findings Multidisciplinary team care at a high-volume institution is instrumental to optimal patient management and outcomes. It is therefore important for all team members to be aware of imaging modality options, strengths, and challenges. Additionally, a high-level understanding of imaging findings is useful clinically. This manuscript provides a current overview of imaging modalities used in the identification and assessment of pancreas adenocarcinoma, including ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography. Imaging findings, including the expected and unexpected, are reviewed to give the novice imager a better understanding. Conclusions This review provides a current overview of imaging for pancreas adenocarcinoma, including strengths and weakness of various imaging modalities; therefore, providing the reader with a robust resource when considering imaging in the management of this disease.

show abstract

Prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case–control study

Cited by 7 publications

References 29 publications

A nomogram diagnostic prediction model of pancreatic metastases of small cell lung carcinoma based on clinical characteristics, radiological features and biomarkers

A nomogram diagnostic prediction model of pancreatic metastases of small cell lung carcinoma based on clinical characteristics, radiological features and biomarkers

Pancreatic Cancer Surveillance and Survival of High-Risk Individuals

A narrative review of imaging for pancreas adenocarcinoma: staging, surgical considerations, and surveillance

Contact Info

Product

Resources

About