Development of pancreatic cancer is predictable well in advance using contrast-enhanced CT: a case–cohort study
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To investigate the radiological findings prognostic for the development of pancreatic adenocarcinoma in a cohort of patients with hepatocellular carcinoma, using multiphasic computed tomography (CT).
A case–cohort study performed in a single university hospital. A database of patients who received hepatocellular carcinoma (HCC) treatment and trimonthly follow-up with four-phase dynamic CT was used (n = 1848). The cohort group was randomly extracted from the database (n = 103). The case group comprised nine patients from the database who developed pancreatic adenocarcinoma. The radiological findings were assessed during follow-up (average, 32 months).
The incidence of pancreatic mass, inhomogeneous parenchyma, loss of fatty marbling and main pancreatic duct dilatation gradually increased from 4 to 13 months before the diagnosis of pancreatic adenocarcinoma. There was a significantly higher incidence of pancreatic mass, inhomogeneous parenchyma and loss of fatty marbling on CT at baseline (average, 34 months before diagnosis) in the case group compared with the cohort group (P values < 0.01) and those findings at baseline were revealed as prognostic factors for pancreatic carcinogenesis, respectively (log-rank test, P values < 0.001).
Several radiological findings observed on multiphasic CT can assist in predicting pancreatic carcinogenesis well in advance.
• Pancreatic findings in multiphasic CT help predict development of pancreatic adenocarcinoma.
• Key findings are mass, inhomogeneous parenchyma and loss of fatty marbling.
• Those findings were observed 34 months before confirmed diagnosis of adenocarcinoma.
• Those findings were prognostic factors for pancreatic carcinogenesis.
KeywordsAdenocarcinoma Pancreas Prognosis Radiology Screening
Abbreviations and acronyms
main pancreatic duct
Compliance with ethical standards
The scientific guarantor of this publication is Kuni Ohtomo (University of Tokyo).
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
The authors state that this work has not received any funding.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Institutional review board approval was obtained.
Written informed consent was waived by the institutional review board.
• case–cohort study
• performed at one institution
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