A study shows that CT and MRI scans fail to detect many cases of pancreatic cancer

A study shows that CT and MRI scans fail to detect many cases of pancreatic cancer

Pancreatic cancer tumors are being missed on CT and MRI scans, narrowing the window of opportunity for life-saving curative surgery, research presented today at UEG Week 2022 shows.

The study analyzed cases of post-imaging pancreatic cancer (PIPC), in which a patient undergoes imaging that fails to diagnose pancreatic cancer, but is then later diagnosed with the disease.

The results showed that over a third (36%) of PIPC cases were potentially preventable, demonstrating a poor cancer detection rate with alarming consequences for patients.

British researchers examined the records of 600 patients diagnosed with pancreatic cancer between 2016 and 2021. Of these patients, 46 (7.7%) patients did not have a diagnosis of cancer at initial examination but received a diagnosis of pancreatic cancer three to 18 months later.

CT and MRI images were reviewed independently by radiologists to develop an algorithm that categorizes the missed cases and determines the most likely explanation for why they were missed.

There is often only a very short period of time available for curative surgery for pancreatic cancer. Therefore, it is important that patients are diagnosed with the disease as early as possible to give them the best chance of survival. The study found that detection of pancreatic cancer was initially missed after imaging in over a third of patients with pancreatic cancer, representing a huge window of missed opportunity.”

Dr. Nosheen Umar, lead author of the study, University of Birmingham, UK

Almost half (48%) of the PIPC patients examined had signs of cancer that had been missed when scans were reviewed by a specialist hepatobiliary radiologist. Imaging signs consistent with pancreatic cancer, such as: B. dilated bile or pancreatic ducts, not recognized and not investigated further.

“We hope this study will raise awareness of the problem of pancreatic cancer after imaging and common reasons why pancreatic cancer may initially be missed,” explained Dr. Umar. “This will help standardize future studies on this topic and guide quality improvement efforts so that we can increase the likelihood of early diagnosis of pancreatic cancer, increase patients’ chances of survival and ultimately save lives.”

Pancreatic cancer is responsible for 95,000 deaths in the EU every year and has the lowest survival rate of any cancer in Europe. Life expectancy at the time of diagnosis is only 4.6 months. By 2035, the number of pancreatic cancer cases is expected to increase by almost 40%.

In many patients, the diagnosis is only made at a late stage because the disease often has unclear early symptoms, making early detection difficult. Symptoms may include jaundice, abdominal and back pain, unexplained weight loss, and nausea. Due to the complex nature of the disease, conducting screening for early diagnosis is also difficult.

Source:

United European Gastroenterology (UEG)

References:

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2. Vereinigte Europäische Gastroenterologie (UEG). UEG-Positionspapier, Bauchspeicheldrüsenkrebs: ein medizinischer Notfall. 2021. Verfügbar unter:
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3. Löhr M. Bauchspeicheldrüsenkrebs sollte als medizinischer Notfall behandelt werden. BMJ. 2014 Sep 4;349:g5261. doi: 10.1136/bmj.g5261. 4. Vereinigte Europäische Gastroenterologie (UEG). Bauchspeicheldrüsenkrebs in ganz Europa: Gemeinsam Stellung beziehen. 2018. Verfügbar unter:
   (Zugriff: Oktober 2022).

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