Early Diagnosis of Pancreatic Cancer 2022–2023

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 17226

Special Issue Editor


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Guest Editor
Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
Interests: imaging diagnosis of early-stage pancreatic cancer, including carcinoma in situ; imaging diagnosis of biliary diseases
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Dear Colleagues, 

Pancreatic cancer (PC) has a poor prognosis because the diagnosis of PC is delayed. To improve the poor prognosis, early diagnosis is needed. For early diagnosis of PC, patients with clinical manifestations suggestive of PC and high risk for developing PC need to be selected for examination for PC. The signs suggestive of PC, such as abdominal symptoms, DM onset, or acute pancreatitis, should not be missed, and the details regarding risk factors for PC including IPMN, chronic pancreatitis, or heredity of PC should be understood. For diagnosing PC, computed tomography (MDCT), magnetic resonance imaging (MRI), and positron emission tomography (PET) could be selected, while the diagnostic ability of these examinations for early stage PC is limited. Recently, endoscopic diagnostic procedures such as endoscopic ultrasonography, including fine-needle aspiration, have been widely accepted for diagnosing PC, including small PC, and endoscopic retrograde pancreatocholangiography using serial pancreatic-juice aspiration cytologic examination (SPACE) has been developed for detailed examination to diagnose earlier pancreatic cancer, including carcinoma in situ.

Dr. Masataka Kikuyama
Guest Editor

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Keywords

  • pancreatic cancer
  • early diagnosis
  • IPMN
  • acute pancreatitis
  • chronic pancreatitis
  • DM
  • heredity
  • CT
  • MRI
  • PET
  • EUS
  • ERCP
  • SPACE

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Published Papers (5 papers)

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Editorial

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9 pages, 1771 KiB  
Editorial
A Novel Diagnostic Imaging Method for the Early Detection of Pancreatic Cancer
by Masataka Kikuyama
Diagnostics 2023, 13(12), 2080; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13122080 - 15 Jun 2023
Viewed by 1107
Abstract
Pancreatic ductal adenocarcinoma (PDAC) has an extremely poor prognosis, with a survival rate of less than 10% [...] Full article
(This article belongs to the Special Issue Early Diagnosis of Pancreatic Cancer 2022–2023)
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Research

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10 pages, 924 KiB  
Article
Comparison of Diagnostic Yield and Safety of Serial Pancreatic Juice Aspiration Cytologic Examination (SPACE) with Different Indications
by Tatsunori Satoh, Shinya Kawaguchi, Shodai Takeda, Yuya Ishiguro, Kazuhisa Asahara, Shuzo Terada, Shinya Endo, Naofumi Shirane, Hideyuki Kanemoto and Kazuya Ohno
Diagnostics 2023, 13(8), 1498; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13081498 - 21 Apr 2023
Viewed by 1141
Abstract
We assessed whether there are differences in the diagnostic yield and safety of serial pancreatic juice aspiration cytologic examination (SPACE) among different indications. We retrospectively analyzed 226 patients who underwent SPACE. They were classified into group A (patients with pancreatic masses, including advanced [...] Read more.
We assessed whether there are differences in the diagnostic yield and safety of serial pancreatic juice aspiration cytologic examination (SPACE) among different indications. We retrospectively analyzed 226 patients who underwent SPACE. They were classified into group A (patients with pancreatic masses, including advanced adenocarcinoma, sclerosing pancreatitis, or autoimmune pancreatitis), group B (suspicious pancreatic carcinoma patients without obvious pancreatic masses, including small pancreatic carcinoma, carcinoma in situ, or benign pancreatic duct stenosis), and group C (intraductal papillary mucinous neoplasm, IPMN). There were 41, 66, and 119 patients, with malignancy diagnosed in 29, 14, and 22 patients, in groups A, B, and C, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 69%, 100%, 100%, 57%, and 78% in group A; 79%, 98%, 92%, 94%, and 94% in group B; and 27%, 87%, 32%, 84%, and 76% in group C, respectively. PEP was observed in three (7.3%), three (4.5%), and fifteen (13%) patients in group A, B, and C, respectively (p = 0.20). SPACE is useful and safe in patients with suspicious small pancreatic carcinoma. However, it has limited efficacy and might not be recommended in patients with IPMN because of the high frequency of PEP. Full article
(This article belongs to the Special Issue Early Diagnosis of Pancreatic Cancer 2022–2023)
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18 pages, 3629 KiB  
Article
Clinical Features and Prognostic Impact of Pancreatic Ductal Adenocarcinoma without Dilatation of the Main Pancreatic Duct: A Single-Center Retrospective Analysis
by Takuya Takayanagi, Yusuke Sekino, Noriki Kasuga, Ken Ishii, Hajime Nagase and Atsushi Nakajima
Diagnostics 2023, 13(5), 963; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13050963 - 03 Mar 2023
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Abstract
The presence of main pancreatic duct (MPD) dilatation is important for diagnosing pancreatic ductal adenocarcinomas (PDACs). However, we occasionally encounter PDAC cases without MPD dilatation. The objectives of this study were to compare the clinical findings and prognosis of pathologically diagnosed PDAC cases [...] Read more.
The presence of main pancreatic duct (MPD) dilatation is important for diagnosing pancreatic ductal adenocarcinomas (PDACs). However, we occasionally encounter PDAC cases without MPD dilatation. The objectives of this study were to compare the clinical findings and prognosis of pathologically diagnosed PDAC cases with and without MPD dilatation and to extract factors related to the prognosis of PDAC. The 281 patients pathologically diagnosed with PDAC were divided into two groups: the dilatation group (n = 215), consisting of patients with MPD dilatation of 3 mm or more, and the non-dilatation group (n = 66), consisting of patients with MPD dilatation less than 3 mm. We found that the non-dilatation group had more cancers in the pancreatic tail, more advanced disease stage, lower resectability, and worse prognoses than the dilatation group. Clinical stage and history of surgery or chemotherapy were identified as significant prognostic factors for PDAC, while tumor location was not. Endoscopic ultrasonography (EUS), diffusion-weighted magnetic resonance imaging (DW-MRI), and contrast-enhanced computed tomography had a high tumor detection rate for PDAC even in the non-dilatation group. Construction of a diagnostic system centered on EUS and DW-MRI is necessary for the early diagnosis of PDAC without MPD dilatation, which can improve its prognosis. Full article
(This article belongs to the Special Issue Early Diagnosis of Pancreatic Cancer 2022–2023)
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16 pages, 2021 KiB  
Article
Effectiveness of Abdominal Ultrasonography for Improving the Prognosis of Pancreatic Cancer during Medical Checkup: A Single Center Retrospective Analysis
by Atsushi Yamaguchi, Naohiro Kato, Shuhei Sugata, Takuro Hamada, Nao Furuya, Takeshi Mizumoto, Yuzuru Tamaru, Ryusaku Kusunoki, Toshio Kuwai, Hirotaka Kouno, Naoyuki Toyota, Takeshi Sudo, Kazuya Kuraoka and Hiroshi Kohno
Diagnostics 2022, 12(12), 2913; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12122913 - 23 Nov 2022
Cited by 2 | Viewed by 1273
Abstract
Recent advancements in surgical and anti-cancer therapies have provided significant hope of long survival in patients with pancreatic cancer (PC). To realize this hope, routine medical checkups of asymptomatic people should be performed to identify operable PCs. In this study, we evaluated the [...] Read more.
Recent advancements in surgical and anti-cancer therapies have provided significant hope of long survival in patients with pancreatic cancer (PC). To realize this hope, routine medical checkups of asymptomatic people should be performed to identify operable PCs. In this study, we evaluated the efficacy of medical checkups using abdominal ultrasonography (US). We retrospectively analyzed 374 patients with PC at our institute between 2010 and 2021. We divided these patients into several groups according to the diagnostic approach and compared their background and prognosis. These groups comprised PCs diagnosed through (a) symptoms, 242 cases; (b) US during medical checkup for asymptomatic individuals, 17; and other means. Of the 374 patients, 192 were men (51.3%), and the median age was 74 years (34–105). Tumors were located in the pancreatic tail in 67 patients (17.9%). Excision ratio and 5-year survival rate were significantly better in group (b) than in (a) (58.8% vs. 23.1%, p < 0.01 and 42.2% vs. 9.4%, p < 0.001, respectively). The prognosis of patients diagnosed using US during medical checkup was better than that of patients identified through symptomatic presentation of PC. US for asymptomatic individuals with PC might be one of the useful modalities for promoting better prognosis of PCs. Full article
(This article belongs to the Special Issue Early Diagnosis of Pancreatic Cancer 2022–2023)
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Review

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15 pages, 3192 KiB  
Review
Current Status of the Diagnosis of Early-Stage Pancreatic Ductal Adenocarcinoma
by Kazunori Nakaoka, Eizaburo Ohno, Naoto Kawabe, Teiji Kuzuya, Kohei Funasaka, Yoshihito Nakagawa, Mitsuo Nagasaka, Takuya Ishikawa, Ayako Watanabe, Takumi Tochio, Ryoji Miyahara, Tomoyuki Shibata, Hiroki Kawashima, Senju Hashimoto and Yoshiki Hirooka
Diagnostics 2023, 13(2), 215; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13020215 - 06 Jan 2023
Cited by 6 | Viewed by 3192
Abstract
Pancreatic ductal adenocarcinoma (PDAC) can be treated with surgery, chemotherapy, and radiotherapy. Despite medical progress in each field in recent years, it is still insufficient for managing PDAC, and at present, the only curative treatment is surgery. A typical pancreatic cancer is relatively [...] Read more.
Pancreatic ductal adenocarcinoma (PDAC) can be treated with surgery, chemotherapy, and radiotherapy. Despite medical progress in each field in recent years, it is still insufficient for managing PDAC, and at present, the only curative treatment is surgery. A typical pancreatic cancer is relatively easy to diagnose with imaging. However, it is often not recommended for surgical treatment at the time of diagnosis due to metastatic spread beyond the pancreas. Even if it is operable, it often recurs during postoperative follow-up. In the case of PDAC with a diameter of 10 mm or less, the 5-year survival rate is as good as 80% or more, and the best index for curative treatment is tumor size. The early detection of pancreatic cancer with a diameter of less than 10 mm or carcinoma in situ is critical. Here, we provide an overview of the current status of diagnostic imaging features and genetic tests for the accurate diagnosis of early-stage PDAC. Full article
(This article belongs to the Special Issue Early Diagnosis of Pancreatic Cancer 2022–2023)
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