Computed tomography (CT) and magnetic resonance imaging (MRI) scans may miss the detection of some pancreatic cancer tumors, narrowing the window for life-saving curative surgery, according to new research presented at the United European Gastroenterology (UEG) Week 2022 (Abstract OP192).
The study, analyzing postimaging pancreatic cancer cases, revealed that 36% of these cases were potentially avoidable, demonstrating a poor detection rate for a cancer characterized by poor patient outcomes. Many patients are diagnosed at a late stage because the disease often presents vague early symptoms, making early recognition challenging. The complex nature of the disease also makes screening for early diagnosis challenging to implement.
Researchers from the United Kingdom studied the records of 600 patients diagnosed with pancreatic cancer between 2016 and 2021. Of those patients, 46 (7.7%) failed to receive a pancreatic cancer diagnosis through their first scan but received a diagnosis between 3 and 18 months later. Radiologists independently reviewed CT and MRI scans to develop an algorithm to categorize the missed cases and identify the most likely explanation for why they were missed.
“There is often only a very short period for curative surgery in pancreatic cancer, meaning it is vital that patients are diagnosed with the disease as early as possible to give them the best chance of survival. [This] study found that evidence of pancreatic cancer was initially missed in over a third of patients [diagnosed] with postimaging pancreatic cancers, which is a huge window of lost opportunity,” said Nosheen Umar, MD, a gastroenterology research fellow at the University of Birmingham.
In 48% of the postimaging pancreatic cancer cases examined, specialist hepatobiliary radiologists who reviewed the scans were able to identify the signs of cancer that had been missed. In 28% of the postimaging pancreatic cancer cases, imaging signs associated with pancreatic cancer, such as dilated bile or pancreatic ducts, were not recognized and required further investigation.
“We hope this study will raise awareness of the issue of postimaging pancreatic cancer and common reasons why pancreatic cancer can be initially missed,” explained Dr. Umar. “This will help to standardize future studies of this issue and guide quality improvement efforts, so we can increase the likelihood of an early diagnosis of pancreatic cancer, increase the chances of patient survival, and, ultimately, save lives.”
Disclosure: For full disclosures of the study authors, visit programme.ueg.eu.
