Undetected pancreatic carcinoma: retrospective analysis of missed findings at computed tomography
Abstract
Purpose Our purpose was to retrospectively investigate whether prediagnostic CT scan may show suggestive findings of early pancreatic cancer.
Material and Methods We searched our radiology and surgery database to identify all patients who had a CT diagnosis of PDA at our institution in a three-year span, and reviewed our PACS system to search whether any of these patients had CT or MR examinations performed before the diagnosis of pancreatic cancer was made. We therefore looked for the presence of pancreatic duct dilatation and/or interruption, distal parenchymal atrophy, contour abnormality and focal hypodense lesion in the prediagnostic CT scans.
Results Three patients had performed previous imaging examinations showing findings suspicious for pancreatic cancer 1-6 months earlier that diagnostic CT. A focal attenuation difference, followed by contour abnormality and upstream pancreatic duct dilatation were the most encountered findings, while upstream pancreatic parenchymal atrophy was encountered just in one patient.
Conclusions Prediagnostic CT can detect findings suggestive of incident early pancreatic cancers. The most common suggestive findings are focal hypodense lesion and pancreatic duct dilatation and/or interruption.
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Siegel RL, Miller KD, Jemal A. Cancer statistics 2015. CA Cancer J Clin 2015; 65(1): 5-29.
Paulson AS, Tran Cao HS, Tempero MA, et al. Therapeutic advances in pancreatic cancer. Gastroenterology 2013; 144(6): 1316-1326.
Ahn SS, Kim MJ, Choi JY, et al. Indicative findings of pancreatic cancer in prediagnostic CT. Eur Radiol 2009; 19(10): 2448-2455.
Bronstein YL, Loyer EM, Kaur H, et al. Detection of small pancreatic tumors with multiphasic helical CT. AJR Am J Roentgenol 2004; 182 (3): 619-623.
Irie H, Honda H, Kaneko K, et al. Comparison of helical CT and MR imaging in detecting and staging small pancreatic adenocarcinoma. Abdom Imaging 1997; 22 (4): 429-433.
Gangi S, Fletcher JG, Nathan MA, et al. Time interval between abnormalities seen on CT and the clinical diagnosis of pancreatic cancer: retrospective review of CT scans obtained before diagnosis. AJR Am J Roentgenol 2004; 182(4): 897-903.
Jang KM, Kim SH, Kim YK,et al. Missed pancreatic ductal adenocarcinoma: Assessment of early imaging findings on prediagnostic magnetic resonance imaging. Eur J Radiol 2015; 84 (8): 1473-1479.
Berlin L. Defending the “missed” radiographic diagnosis. AJR Am J Roentgenol 2001; 176(2): 317-322.
Berlin L, Hendrix RW. Perceptual errors and negligence. AJR Am J Roentgenol 1998; 170(4): 863-867.
Eberhardt SC, Eberhardt SC, Johnson JA, et al. Oncology imaging in the abdomen and pelvis: where cancer hides. Abdom Imaging 2013; 38(4): 647-671.
Vernuccio F, Borhani AA, Dioguardi Burgio M, et al. Common and uncommon pitfalls in pancreatic imaging: it is not always cancer. Abdom Radiol (NY) 2016; 41(2): 283-294.
Fukumoto T, Watanabe T, Hirai I, et al. Pancreatic volume is one of the independent prognostic factors for resectable pancreatic ductal adenocarcinomas. J Hepatobiliary Pancreat Sci 2016; 23(8): 472-479.
Kim JK, Altun E, Elias J Jr, et al. Focal pancreatic mass: distinction of pancreatic cancer from chronic pancreatitis using gadolinium-enhanced 3D-gradient-echo MRI. J Magn Reson Imaging 2007; 26(2): 313-322.
Siewert B, Sosna J, McNamara A, et al. Missed lesions at abdominal oncologic CT: lessons learned from quality assurance. Radiographics 2008; 28(3): 623-638.
DOI: http://dx.doi.org/10.36162/hjr.v2i3.155
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