Undetected pancreatic carcinoma: retrospective analysis of missed findings at computed tomography

Federica Vernuccio, Massimo Midiri, Roberto Lagalla, Giuseppe Brancatelli


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.


pancreatic neoplasms; multidetector computed tomography; early diagnosis/indolent tumour

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DOI: http://dx.doi.org/10.36162/hjr.v2i3.155


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