316 The Phenotype of Familial Pancreatic Neoplasia

“…Several studies in the literature have shown that MRI can be useful for the detection not only of small cystic lesions, but even of early solid tumors of the pancreas. 25,31 Furthermore, data in the current study demonstrate that detection of early pancreatic cancer (T1N0M0) was possible in 1 of the patients when using MRI only. Conversely, even in a patient who was under surveillance for IPMNs with MRI and EUS at 6-month intervals, PDAC was detected only at stage T3N0M0.…”

“…56 In The Johns Hopkins screening program, 21.7% of screened individuals who had either partial or total pancreatectomy had PanIN 3 (carcinoma in situ), including one with a microinvasive ductal adenocarcinoma. 55 Similarly, multifocal PanIN grades I to III (Bdysplasia[) and unusual pancreatic carcinomas (small cell undifferentiated carcinoma and giant cell anaplastic carcinoma) have also been reported in the resected pancreata of high-risk individuals with abnormal pancreata by EUS and ERCP from the University of Washington in Seattle screening program. 58,65 The optimal approach for and diagnostic yield of screening of high-risk individuals with hereditary pancreatitis are also unclear.…”

“…In this study of 225 patients at high risk for pancreas cancer, 92 patients were found by EUS to have at least one pancreatic abnormality (84 cystic lesions, 3 neuroendocrine tumors, and 5 dilated pancreatic duct), although no patients were diagnosed with pancreatic adenocarcinoma. 10 Among the diagnostic tests, EUS was the most sensitive in finding pancreatic abnormalities (42.6%), followed by MRI (33.3%) and CT (11%).…”