ArticlePancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]2020
Computerized tomography scan in pre-diagnostic pancreatic ductal adenocarcinoma: Stages of progression and potential benefits of early intervention: A retrospective study.
Article in Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 58 citations in OpenAlex.
- Early Detection Initiative: A randomized controlled trial of algorithm-based screening in patients with new onset hyperglycemia and diabetes for early detection of pancreatic ductal adenocarcinoma.Contemporary clinical trials · 2022Trial
- Heuriskance: a novel paradigm for systematic earlier detection of sporadic pancreatic cancer.Journal of the National Cancer Institute · 2026Article
- From Bench to Bedside: The Path Toward Real-World Translation for Artificial Intelligence in Pancreatic Cancer Detection.Korean journal of radiology · 2026Review
- A machine learning-based interpretable model for predicting pancreatic cancer in chronic pancreatitis patients with focal pancreatic lesions.BMC cancer · 2026Article
- AI-Driven insights in pancreatic cancer imaging: from pre-diagnostic detection to prognostication.Abdominal radiology (New York) · 2025Review
- Advancements in early detection of pancreatic cancer: the role of artificial intelligence and novel imaging techniques.Abdominal radiology (New York) · 2025Review
- Early detection of pancreatic cancer in the era of precision medicine.Abdominal radiology (New York) · 2024Review
- Hidden in plain sight: commonly missed early signs of pancreatic cancer on CT.Abdominal radiology (New York) · 2024Review
- Imaging for Early Detection of Pancreatic Ductal Adenocarcinoma: Updates and Challenges in the Implementation of Screening and Surveillance Programs.AJR. American journal of roentgenology · 2024Review
- The role of biomarkers in the early detection of pancreatic cancer.Familial cancer · 2024Review
- Article
- Assessing the robustness of a machine-learning model for early detection of pancreatic adenocarcinoma (PDA): evaluating resilience to variations in image acquisition and radiomics workflow using image perturbation methods.Abdominal radiology (New York) · 2024Article
- Article
- Computer-Aided Detection for Pancreatic Cancer Diagnosis: Radiological Challenges and Future Directions.Journal of clinical medicine · 2023Review
- Diffuse pancreatic parenchymal atrophy, an imaging finding predictive of the development of pancreatic ductal adenocarcinoma: A case-control study.JGH open : an open access journal of gastroenterology and hepatology · 2023Article
- Pancreatic Cancer: Changing Epidemiology and New Approaches to Risk Assessment, Early Detection, and Prevention.Gastroenterology · 2023Article
- Prevalence, features, and explanations of missed and misinterpreted pancreatic cancer on imaging: a matched case-control study.Abdominal radiology (New York) · 2022Article
- A Growing Hope for Earlier Detection of Pancreatic Cancer.Gastroenterology · 2022Article
- Radiomics-based Machine-learning Models Can Detect Pancreatic Cancer on Prediagnostic Computed Tomography Scans at a Substantial Lead Time Before Clinical Diagnosis.Gastroenterology · 2022Article
- Setting the Research Agenda for Clinical Artificial Intelligence in Pancreatic Adenocarcinoma Imaging.Cancers · 2022Review
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Authors and funding
14 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe frequency, nature and timeline of changes on thin-slice (≤3 mm) multi-detector computerized tomography (CT) scans in the pre-diagnostic phase of pancreatic ductal adenocarcinoma (PDAC) are unknown. It is unclear if identifying imaging changes in this phase will improve PDAC survival beyond lead time.
methodsFrom a cohort of 128 subjects (Cohort A) with CT scans done 3-36 months before diagnosis of PDAC we developed a CTgram defining CT Stages (CTS) I through IV in the radiological progression of pre-diagnostic PDAC. We constructed Cohort B of PDAC resected at CTS I and II and compared survival in CTS I and II in Cohort A (n = 22 each; control natural history cohort) vs Cohort B (n = 33 and 72, respectively; early interception cohort).
resultsCTs were abnormal in 16% and 85% at 24-36 and 3-6 months respectively, before PDAC diagnosis. The PDAC CTgram stages, findings and median lead times (months) to clinical diagnosis were: CTS I: Abrupt duct cut-off/duct dilatation (-12.8); CTS II: Low density mass confined to pancreas (-9.5), CTS III: Peri-pancreatic infiltration (-5.8), CTS IV: Distant metastases (only at diagnosis). PDAC survival was better in cohort B than in cohort A despite inclusion of lead time in Cohort A: CTS I (36 vs 17.2 months, p = 0.03), CTS II (35.2 vs 15.3 months, p = 0.04).
conclusionStarting 12-18 months before PDAC diagnosis, progressive and increasingly frequent changes occur on CT scans. Resection of PDAC at the time of pre-diagnostic CT changes is likely to provide survival benefit beyond lead time.
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