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Prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case–control study
PURPOSE: To characterize the prevalence of missed pancreatic masses and pancreatic ductal adenocarcinoma (PDAC)-related findings on CT and MRI between pre-diagnostic patients and healthy individuals. MATERIALS AND METHODS: Patients diagnosed with PDAC (2010–2016) were retrospectively reviewed for ab...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9626431/ https://www.ncbi.nlm.nih.gov/pubmed/36127473 http://dx.doi.org/10.1007/s00261-022-03671-6 |
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author | Hoogenboom, Sanne A. Engels, Megan M. L. Chuprin, Anthony V. van Hooft, Jeanin E. LeGout, Jordan D. Wallace, Michael B. Bolan, Candice W. |
author_facet | Hoogenboom, Sanne A. Engels, Megan M. L. Chuprin, Anthony V. van Hooft, Jeanin E. LeGout, Jordan D. Wallace, Michael B. Bolan, Candice W. |
author_sort | Hoogenboom, Sanne A. |
collection | PubMed |
description | PURPOSE: To characterize the prevalence of missed pancreatic masses and pancreatic ductal adenocarcinoma (PDAC)-related findings on CT and MRI between pre-diagnostic patients and healthy individuals. MATERIALS AND METHODS: Patients diagnosed with PDAC (2010–2016) were retrospectively reviewed for abdominal CT- or MRI-examinations 1 month—3 years prior to their diagnosis, and subsequently matched to controls in a 1:4 ratio. Two blinded radiologists scored each imaging exam on the presence of a pancreatic mass and secondary features of PDAC. Additionally, original radiology reports were graded based on the revised RADPEER criteria. RESULTS: The cohort of 595 PDAC patients contained 60 patients with a pre-diagnostic CT and 27 with an MRI. A pancreatic mass was suspected in hindsight on CT in 51.7% and 50% of cases and in 1.3% and 0.9% of controls by reviewer 1 (p < .001) and reviewer 2 (p < .001), respectively. On MRI, a mass was suspected in 70.4% and 55.6% of cases and 2.9% and 0% of the controls by reviewer 1 (p < .001) and reviewer 2 (p < .001), respectively. Pancreatic duct dilation, duct interruption, focal atrophy, and features of acute pancreatitis is strongly associated with PDAC (p < .001). In cases, a RADPEER-score of 2 or 3 was assigned to 56.3% of the CT-reports and 71.4% of MRI-reports. CONCLUSION: Radiological features as pancreatic duct dilation and interruption, and focal atrophy are common first signs of PDAC and are often missed or unrecognized. Further investigation with dedicated pancreas imaging is warranted in patients with PDAC-related radiological findings. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00261-022-03671-6. |
format | Online Article Text |
id | pubmed-9626431 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-96264312022-11-03 Prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case–control study Hoogenboom, Sanne A. Engels, Megan M. L. Chuprin, Anthony V. van Hooft, Jeanin E. LeGout, Jordan D. Wallace, Michael B. Bolan, Candice W. Abdom Radiol (NY) Pancreas PURPOSE: To characterize the prevalence of missed pancreatic masses and pancreatic ductal adenocarcinoma (PDAC)-related findings on CT and MRI between pre-diagnostic patients and healthy individuals. MATERIALS AND METHODS: Patients diagnosed with PDAC (2010–2016) were retrospectively reviewed for abdominal CT- or MRI-examinations 1 month—3 years prior to their diagnosis, and subsequently matched to controls in a 1:4 ratio. Two blinded radiologists scored each imaging exam on the presence of a pancreatic mass and secondary features of PDAC. Additionally, original radiology reports were graded based on the revised RADPEER criteria. RESULTS: The cohort of 595 PDAC patients contained 60 patients with a pre-diagnostic CT and 27 with an MRI. A pancreatic mass was suspected in hindsight on CT in 51.7% and 50% of cases and in 1.3% and 0.9% of controls by reviewer 1 (p < .001) and reviewer 2 (p < .001), respectively. On MRI, a mass was suspected in 70.4% and 55.6% of cases and 2.9% and 0% of the controls by reviewer 1 (p < .001) and reviewer 2 (p < .001), respectively. Pancreatic duct dilation, duct interruption, focal atrophy, and features of acute pancreatitis is strongly associated with PDAC (p < .001). In cases, a RADPEER-score of 2 or 3 was assigned to 56.3% of the CT-reports and 71.4% of MRI-reports. CONCLUSION: Radiological features as pancreatic duct dilation and interruption, and focal atrophy are common first signs of PDAC and are often missed or unrecognized. Further investigation with dedicated pancreas imaging is warranted in patients with PDAC-related radiological findings. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00261-022-03671-6. Springer US 2022-09-21 2022 /pmc/articles/PMC9626431/ /pubmed/36127473 http://dx.doi.org/10.1007/s00261-022-03671-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Pancreas Hoogenboom, Sanne A. Engels, Megan M. L. Chuprin, Anthony V. van Hooft, Jeanin E. LeGout, Jordan D. Wallace, Michael B. Bolan, Candice W. Prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case–control study |
title | Prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case–control study |
title_full | Prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case–control study |
title_fullStr | Prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case–control study |
title_full_unstemmed | Prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case–control study |
title_short | Prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case–control study |
title_sort | prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case–control study |
topic | Pancreas |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9626431/ https://www.ncbi.nlm.nih.gov/pubmed/36127473 http://dx.doi.org/10.1007/s00261-022-03671-6 |
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