Skip to main content

Advertisement

SpringerLink
Log in

Incidentally detected pancreatic adenocarcinomas on computed tomography obtained during the follow-up for other diseases

  • Pancreas
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To determine imaging findings of pancreatic adenocarcinomas incidentally detected on contrast-enhanced multiphasic dynamic computed tomography (CT) obtained during the follow-up for other diseases.

Methods

From January 2007 to December 2018, 14 patients with pancreatic adenocarcinomas incidentally detected on CT obtained during the follow-up for other diseases (incidental group) and 105 patients with pancreatic adenocarcinomas symptomatically detected on ultrasound or CT (non-incidental group) were included. Imaging characteristics of the tumor were compared between the two groups. Additionally, imaging findings prior to the detection of a tumor on previous CT images in the incidental group were also assessed.

Results

In cancers of the pancreas body/tail, there was a significantly smaller tumor size (median, 17 mm vs. 42 mm, p < 0.001), a significantly lower incidence of loss of fatty marbling (p = 0.025), vascular involvement (p < 0.001), lymph node metastasis (p = 0.046) and distant metastasis (p = 0.017), and a significantly higher incidence of preserved lobulation (p < 0.001) in the incidental group than in the non-incidental group. Regarding the cancers of the pancreas head, there were no significant differences in the radiological findings between the two groups. On previous CT images, small pancreatic nodules, secondary signs, and loss of fatty marbling tended to be the preceding findings of incidental pancreatic adenocarcinomas.

Conclusion

Incidentally detected pancreatic adenocarcinomas in the pancreas body/tail were characterized by an earlier tumor stage than in cases of symptomatically detected pancreatic adenocarcinoma. Several CT findings prior to the detection of a tumor may be useful for the early detection of pancreatic adenocarcinoma during the follow-up for other diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394-424

    Article  Google Scholar 

  2. Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P (2012) Pancreatic cancer: overview of descriptive epidemiology. Mol Carcinog 51:3-13

    Article  CAS  Google Scholar 

  3. Lambe M, Eloranta S, Wigertz A, Blomqvist P (2011) Pancreatic cancer; reporting and long-term survival in Sweden. Acta Oncol 50:1220-1227

    Article  Google Scholar 

  4. Oberstein PE, Olive KP (2013) Pancreatic cancer: why is it so hard to treat? Therap Adv Gastroenterol 6:321-337

    Article  Google Scholar 

  5. Egawa S, Takeda K, Fukuyama S, Motoi F, Sunamura M, Matsuno S (2004) Clinicopathological aspects of small pancreatic cancer. Pancreas 28:235-240

    Article  Google Scholar 

  6. Lahat G, Ben Haim M, Nachmany I et al (2009) Pancreatic incidentalomas: high rate of potentially malignant tumors. J Am Coll Surg 209:313-319

    Article  Google Scholar 

  7. Santo E, Bar-Yishay I (2017) Pancreatic solid incidentalomas. Endosc Ultrasound 6:S99-s103

    Google Scholar 

  8. Takeda Y, Saiura A, Takahashi Y et al (2017) Asymptomatic Pancreatic Cancer: Does Incidental Detection Impact Long-Term Outcomes? J Gastrointest Surg 21:1287-1295

    Article  Google Scholar 

  9. Winter JM, Cameron JL, Lillemoe KD et al (2006) Periampullary and pancreatic incidentaloma: a single institution’s experience with an increasingly common diagnosis. Ann Surg 243:673-680; discussion 680-673

    Article  Google Scholar 

  10. Ahn SS, Kim MJ, Choi JY, Hong HS, Chung YE, Lim JS (2009) Indicative findings of pancreatic cancer in prediagnostic CT. Eur Radiol 19:2448-2455

    Article  Google Scholar 

  11. Yoon SH, Lee JM, Cho JY et al (2011) Small (</= 20 mm) pancreatic adenocarcinomas: analysis of enhancement patterns and secondary signs with multiphasic multidetector CT. Radiology 259:442-452

    Article  Google Scholar 

  12. Gonoi W, Hayashi TY, Okuma H et al (2017) Development of pancreatic cancer is predictable well in advance using contrast-enhanced CT: a case-cohort study. Eur Radiol 27:4941-4950

    Article  Google Scholar 

  13. Berland LL, Lawson TL, Foley WD, Greenen JE, Stewart ET (1981) Computed tomography of the normal and abnormal pancreatic duct: correlation with pancreatic ductography. Radiology 141:715-724

    Article  CAS  Google Scholar 

  14. Karasawa E, Goldberg HI, Moss AA, Federle MP, London SS (1983) CT pancreatogram in carcinoma of the pancreas and chronic pancreatitis. Radiology 148:489-493

    Article  CAS  Google Scholar 

  15. Tamada T, Ito K, Kanomata N et al (2016) Pancreatic adenocarcinomas without secondary signs on multiphasic multidetector CT: association with clinical and histopathologic features. Eur Radiol 26:646-655

    Article  Google Scholar 

  16. Gilbeau JP, Poncelet V, Libon E, Derue G, Heller FR (1992) The density, contour, and thickness of the pancreas in diabetics: CT findings in 57 patients. AJR Am J Roentgenol 159:527-531

    Article  CAS  Google Scholar 

  17. Hong SB, Lee SS, Kim JH et al (2018) Pancreatic Cancer CT: Prediction of Resectability according to NCCN Criteria. Radiology 289:710-718

    Article  Google Scholar 

  18. Birchard KR, Semelka RC, Hyslop WB et al (2005) Suspected pancreatic cancer: evaluation by dynamic gadolinium-enhanced 3D gradient-echo MRI. AJR Am J Roentgenol 185:700-703

    Article  Google Scholar 

  19. Takeshita K, Kutomi K, Haruyama T et al (2010) Imaging of early pancreatic cancer on multidetector row helical computed tomography. Br J Radiol 83:823-830

    Article  CAS  Google Scholar 

  20. (1999) American gastroenterological association medical position statement: epidemiology, diagnosis, and treatment of pancreatic ductal adenocarcinoma. Gastroenterology 117:1463-1484

  21. Kalser MH, Barkin J, MacIntyre JM (1985) Pancreatic cancer. Assessment of prognosis by clinical presentation. Cancer 56:397-402

    Article  CAS  Google Scholar 

  22. Gangi S, Fletcher JG, Nathan MA et al (2004) 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 182:897-903

    Article  Google Scholar 

  23. Shen M, Boffetta P, Olsen JH et al (2006) A pooled analysis of second primary pancreatic cancer. Am J Epidemiol 163:502-511

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan

    Mayumi Higashi, Masahiro Tanabe, Hideko Onoda, Sei Nakao, Keisuke Miyoshi, Etsushi Iida, Munemasa Okada, Matakazu Furukawa & Katsuyoshi Ito

Authors
  1. Mayumi Higashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masahiro Tanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hideko Onoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sei Nakao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Keisuke Miyoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Etsushi Iida
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Munemasa Okada
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Matakazu Furukawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Katsuyoshi Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mayumi Higashi.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Higashi, M., Tanabe, M., Onoda, H. et al. Incidentally detected pancreatic adenocarcinomas on computed tomography obtained during the follow-up for other diseases. Abdom Radiol 45, 774–781 (2020). https://doi.org/10.1007/s00261-019-02365-w

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-019-02365-w

Keywords

Search

Navigation