High signal intensity on diffusion-weighted magnetic resonance images is a useful finding for detecting early-stage pancreatic cancer
Open accessAbstract
Purpose: Early detection of pancreatic ductal adenocarcinoma (PDAC) may improve the prognosis. We evaluated novel imaging findings that may contribute to early detection. Methods: This single-center, retrospective study enrolled 37 patients with a localized main pancreatic duct (MPD) stricture and no obvious pancreatic mass. All patients underwent endoscopic retrograde cholangiopancreatography and brush sampling with cytology and serial pancreatic juice aspiration cytologic examination via endoscopic naso-pancreatic drainage. Patients with cytology-confirmed malignancy underwent surgical resection. The remaining patients were followed by contrast-enhanced computed tomography (CECT), magnetic resonance imaging (MRI), and endoscopic retrograde cholangiopancreatography. Results: Twenty patients had confirmed malignancy (cancer group) and 17 did not (non-cancer group). Age, MPD stricture location, and PDAC risk factors were similar, but the sex predominance and symptom rate differed between the two groups. In the cancer group, 17 patients were diagnosed by cytology and three by clinical symptoms. CECT, MRI, and endoscopic ultrasonography (EUS) revealed no solid tumors in either group. CECT revealed no significant differences between groups. Diffusion-weighted MRI revealed significant differences in the signal intensity between groups. EUS detected indistinct and small hypoechoic areas in 70% and 41.2% of patients in the cancer and non-cancer groups, respectively. In the cancer group, 11 were diagnosed with cancer at the first indication, and nine were diagnosed at follow-up; the prognosis did not differ between these two subgroups.ss Conclusions: High signal intensity in diffusion-weighted MRI may be useful for detecting early-stage PDAC and may be an indication for surgical resection even without pathologic confirmation. Clinical trial registration: The study was a registered at the University Hospital Medical Information Network (UMIN000039623). Graphic abstract:
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In three case series studies of localized main pancreatic duct stricture without a detectable mass, 47-54% of cases were actually diagnosed with pancreatic cancer.
“In three case series studies of localized main pancreatic duct structure without a detectable mass, 47–54% of cases were actually diagnosed with pancreatic cancer (31-33).”
From Suspicious findings observed retrospectively on CT imaging performed before the diagnosis of pancreatic cancer (2023) · cites this paper as [33]
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Cites
Siegel, R. L., Miller, K. D., & Jemal, A. (2018) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.21442 · Cited by 16,632 · see citing works
Spencer, P. M., Cameron, J. L., & Lin, L. (2000) · Cited by 7,202 · see citing works
Rahib, L., Smith, B. D., Aizenberg, R., Rosenzweig, A. B., Fleshman, J. M., & Matrisian, L. M. (2014) · Cancer Research · doi:10.1158/0008-5472.can-14-0155 · Cited by 7,094 · see citing works
Kamisawa, T., Wood, L. D., Itoi, T., & Takaori, K. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00141-0 · Cited by 2,212 · see citing works
Diffusion-Weighted MRI in the Body: Applications and Challenges in Oncology
Koh, D., & Collins, D. J. (2007) · American Journal of Roentgenology · doi:10.2214/ajr.06.1403 · Cited by 1,999 · see citing works
Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes
McGuigan, A. J., Kelly, P. J., Turkington, R. C., Jones, C. A., Coleman, H. G., & McCain, R. S. (2018) · World Journal of Gastroenterology · doi:10.3748/wjg.v24.i43.4846 · Cited by 1,934 · see citing works
Epidemiology of pancreatic cancer
Ilić, M., & Ilić, I. (2016) · World Journal of Gastroenterology · doi:10.3748/wjg.v22.i44.9694 · Cited by 1,306 · see citing works
Canto, M. I., Harinck, F., Hruban, R. H., Offerhaus, G. J., Poley, J.-W., Kamel, I., Nio, Y., Schulick, R. S., Bassi, C., Kluijt, I., et al. (2013) · Gut · doi:10.1136/gutjnl-2012-303108 · Cited by 784 · see citing works
Goggins, M., Overbeek, K. A., Brand, R., Syngal, S., Del Chiaro, M., Bartsch, D. K., Bassi, C., Carrato, A., Farrell, J., Fishman, E. K., et al. (2020) · Gut · doi:10.1136/gutjnl-2019-319352 · Cited by 659 · see citing works
Japan Pancreatic Cancer Registry; 30th Year Anniversary
Egawa, S., Toma, H., Ohigashi, H., Okusaka, T., Nakao, A., Hatori, T., Maguchi, H., Yanagisawa, A., & Tanaka, M. (2012) · Pancreas · doi:10.1097/mpa.0b013e318258055c · Cited by 436 · see citing works
Brentnall, T. A., Bronner, M. P., Byrd, D. R., Haggitt, R. C., & Kimmey, M. B. (1999) · Annals of Internal Medicine · doi:10.7326/0003-4819-131-4-199908170-00003 · Cited by 391 · see citing works
Multicenter study of early pancreatic cancer in Japan
Kanno, A., Masamune, A., Hanada, K., Maguchi, H., Shimizu, Y., Ueki, T., Hasebe, O., Ohtsuka, T., Nakamura, M., Takenaka, M., et al. (2018) · Pancreatology · doi:10.1016/j.pan.2017.11.007 · Cited by 291 · see citing works
Pancreatic Cancer: Pathogenesis and Diagnosis
Göral, V. (2015) · Asian Pacific Journal of Cancer Prevention · doi:10.7314/apjcp.2015.16.14.5619 · Cited by 260 · see citing works
High-b Value Diffusion-Weighted MRI for Detecting Pancreatic Adenocarcinoma: Preliminary Results
Ichikawa, T., Ertürk, Ş. M., Motosugi, U., Sou, H., Iino, H., Araki, T., & Fujii, H. (2007) · American Journal of Roentgenology · doi:10.2214/ajr.05.1918 · Cited by 251 · see citing works
Rebours, V., Gaujoux, S., d’Assignies, G., Sauvanet, A., Ruszniewski, P. B., Lévy, P., Paradis, V., Bédossa, P., & Couvelard, A. (2015) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-14-2385 · Cited by 217 · see citing works
Alcohol Intake and Pancreatic Cancer Risk: A Pooled Analysis of Fourteen Cohort Studies
Genkinger, J. M., Spiegelman, D. L., Anderson, K. E., Bergkvist, L., Bernstein, L., van den Brandt, P. A., English, D. R., Freudenheim, J. L., Fuchs, C. S., Giles, G. G., et al. (2009) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-08-0880 · Cited by 202 · see citing works
Fattahi, R., Balci, N. C., Perman, W. H., Hsueh, E. C., Alkaade, S., Havlioglu, N., & Burton, F. R. (2009) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.21651 · Cited by 195 · see citing works
Nationwide trends in incidence, treatment and survival of pancreatic ductal adenocarcinoma
Latenstein, A. E. J., van der Geest, L. G., Bonsing, B. A., Koerkamp, B. G., Mohammad, N. H., de Hingh, I. H. J. T., de Meijer, V. E., Molenaar, I. Q., van Santvoort, H. C., van Tienhoven, G., et al. (2019) · European Journal of Cancer · doi:10.1016/j.ejca.2019.11.002 · Cited by 187 · see citing works
Harinck, F., Konings, I. C. A. W., Kluijt, I., Poley, J. W., van Hooft, J. E., van Dullemen, H. M., Nio, C. Y., Krak, N. C., Hermans, J. J., Aalfs, C. M., et al. (2016) · Gut · doi:10.1136/gutjnl-2014-308008 · Cited by 185 · see citing works
Pancreatic and bile duct brushing cytology in 1000 cases
Volmar, K. E., Vollmer, R. T., Routbort, M. J., & Creager, A. J. (2006) · Cancer · doi:10.1002/cncr.21842 · Cited by 169 · see citing works
Diffusion-weighted magnetic resonance imaging of pancreas tumours
Kartalis, N., Lindholm, T. L., Aspelin, P., Permert, J., & Albiin, N. (2009) · European Radiology · doi:10.1007/s00330-009-1384-8 · Cited by 167 · see citing works
Whitcomb, D. C., Shimosegawa, T., Chari, S. T., Forsmark, C. E., Frulloni, L., Garg, P. K., Hegyi, P., Hirooka, Y., Irisawa, A., Ishikawa, T., et al. (2018) · Pancreatology · doi:10.1016/j.pan.2018.05.008 · Cited by 158 · see citing works
Iiboshi, T., Hanada, K., Fukuda, T., Yonehara, S., Sasaki, T., & Chayama, K. (2012) · Pancreas · doi:10.1097/mpa.0b013e31823c0b05 · Cited by 142 · see citing works
Endo, Y., Morii, T., Tamura, H., & Okuda, S. (1974) · Gastroenterology · doi:10.1016/s0016-5085(19)32748-9 · Cited by 125 · see citing works
Corral, J. E., Mareth, K. F., Riegert-Johnson, D. L., Das, A., & Wallace, M. B. (2019) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2018.04.065 · Cited by 113 · see citing works
Cytologic Criteria for the Diagnosis of Pancreatic Carcinoma
Mitchell, M. L., & Carney, C. N. (1985) · American Journal of Clinical Pathology · doi:10.1093/ajcp/83.2.171 · Cited by 107 · see citing works
Pancreatic Adenocarcinoma: Variability of Diffusion-weighted MR Imaging Findings
Fukukura, Y., Takumi, K., Kamimura, K., Shindo, T., Kumagae, Y., Tateyama, A., & Nakajo, M. (2012) · Radiology · doi:10.1148/radiol.12111222 · Cited by 99 · see citing works
Hatfield, A. R., Smithies, A., Wilkins, R., & Levi, A. J. (1976) · Gut · doi:10.1136/gut.17.1.14 · Cited by 99 · see citing works
Pancreatic Duct: Morphologic Evaluation with MR Cholangiopancreatography after Secretin Stimulation
Fukukura, Y., Fujiyoshi, F., Sasaki, M., & Nakajo, M. (2002) · Radiology · doi:10.1148/radiol.2223010684 · Cited by 97 · see citing works
Brush cytology for pancreatic carcinoma: an analysis of factors influencing results
McGuire, D. E., Venu, R. P., Brown, R. D., Etzkorn, K. P., Glaws, W. R., & Abu-Hammour, A. (1996) · Gastrointestinal Endoscopy · doi:10.1016/s0016-5107(96)70168-2 · Cited by 94 · see citing works
Tsushima, Y., Takano, A., Taketomi-Takahashi, A., & Endo, K. (2007) · Academic Radiology · doi:10.1016/j.acra.2007.02.006 · Cited by 92 · see citing works
Mikata, R., Ishihara, T., Tada, M., Tawada, K., Saito, M., Kurosawa, J., Sugiyama, H., Sakai, Y., Tsuyuguchi, T., Miyazaki, M., et al. (2012) · Journal of Gastroenterology · doi:10.1007/s00535-012-0684-y · Cited by 82 · see citing works
Diffusion-weighted imaging of pancreatic cancer
Robertis, R. D. (2015) · World Journal of Radiology · doi:10.4329/wjr.v7.i10.319 · Cited by 74 · see citing works
Park, M. J., Kim, Y. K., Choi, S., Rhim, H., Lee, W. J., & Choi, D. (2014) · Radiology · doi:10.1148/radiol.14132563 · Cited by 73 · see citing works
Variation in Precursor Lesions of Pancreatic Cancer among High-Risk Groups
Potjer, T. P., Schot, I., Langer, P., Heverhagen, J. T., Wasser, M. N. J. M., Slater, E. P., Klöppel, G., Morreau, H. M., Bonsing, B. A., Cappel, W. H. D. V. T. N., et al. (2012) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-12-2730 · Cited by 67 · see citing works
Paiella, S., Salvia, R., de Pastena, M., Pollini, T., Casetti, L., Landoni, L., Esposito, A., Marchegiani, G., Malleo, G., de Marchi, G., et al. (2018) · Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · doi:10.1016/j.pan.2018.04.002 · Cited by 63 · see citing works
Satoh, T., Kikuyama, M., Kawaguchi, S., Kanemoto, H., Muro, H., & Hanada, K. (2017) · Clinical Journal of Gastroenterology · doi:10.1007/s12328-017-0776-6 · Cited by 56 · see citing works
Isolated Main Pancreatic Duct Dilatation: CT Differentiation Between Benign and Malignant Causes
Kim, S. W., Kim, S. H., Lee, D. H., Lee, S. M., Kim, Y. S., Jang, J. Y., & Han, J. K. (2017) · American Journal of Roentgenology · doi:10.2214/ajr.17.17963 · Cited by 55 · see citing works
Paiella, S., Capurso, G., Cavestro, G. M., Butturini, G., Pezzilli, R., Salvia, R., Signoretti, M., Crippa, S., Carrara, S., Frigerio, I. M., et al. (2018) · The American Journal of Gastroenterology · doi:10.1038/s41395-018-0414-z · Cited by 51 · see citing works
Obesity and pancreatic cancer: An update of epidemiological evidence and molecular mechanisms
Zhou, B., Wu, D., Liu, H., Du, L., Wang, Y., Xu, J., Qiu, F., Hu, S., & Zhan, H. (2019) · Pancreatology · doi:10.1016/j.pan.2019.08.008 · Cited by 47 · see citing works
Yokode, M., Akita, M., Fujikura, K., Kim, M., Morinaga, Y., Yoshikawa, S., Terada, T., Matsukiyo, H., Tajiri, T., Abe‐Suzuki, S., et al. (2018) · Histopathology · doi:10.1111/his.13629 · Cited by 44 · see citing works
Chiaro, M. D., Zerbi, A., Capurso, G., Zamboni, G., Maisonneuve, P., Presciuttini, S., Arcidiacono, P. G., Calculli, L., & Falconi, M. (2010) · Digestive and Liver Disease · doi:10.1016/j.dld.2010.04.016 · Cited by 43 · see citing works
Early diagnosis of pancreatic cancer: Current trends and concerns
Hanada, K., Amano, H., & Abe, T. (2017) · Annals of Gastroenterological Surgery · doi:10.1002/ags3.12004 · Cited by 33 · see citing works
A Case of Pancreatic Carcinoma in situ Diagnosed by Repeated Pancreatic Juice Cytology
Miyata, T., Takenaka, M., Omoto, S., Kamata, K., Minaga, K., Yamao, K., Imai, H., & Kudo, M. (2017) · Oncology · doi:10.1159/000481240 · Cited by 18 · see citing works
Long-term positive psychological outcomes in an Australian pancreatic cancer screening program
O'Neill, R. S., Meiser, B., Emmanuel, S., Williams, D. B., & Stoita, A. (2019) · Familial Cancer · doi:10.1007/s10689-019-00147-3 · Cited by 16 · see citing works
Pancreatic Cancer Surveillance: Who, When, and How
Dudley, B., & Brand, R. E. (2019) · Current Treatment Options in Gastroenterology · doi:10.1007/s11938-019-00247-0 · Cited by 12 · see citing works
Ma, C., Li, J., Boukar, M. B., Yang, P., Wang, L., Chen, L., Su, L., Qu, J., Chen, S.-Y., Hao, Q., et al. (2017) · Oncotarget · doi:10.18632/oncotarget.18457 · Cited by 10 · see citing works
In situ carcinoma of pancreas diagnosed by EUS-FNA
Sakamoto, H., Kitano, M., Dote, K., Tchikugo, T., Takeyama, Y., & Kudo, M. (2008) · Endoscopy · doi:10.1055/s-2007-966708 · Cited by 9 · see citing works
Hemosuccus pancreaticus caused by in situ carcinoma of the pancreas
Inoue, H., Katurahara, M., Hamada, Y., Ninomiya, K., Tano, S., Takayama, R., Nojiri, K., Tameda, M., Horiki, N., & Takei, Y. (2012) · Endoscopy · doi:10.1055/s-0032-1309863 · Cited by 8 · see citing works
Yamao, K., Takenaka, M., Nakai, A., Omoto, S., Kamata, K., Minaga, K., Miyata, T., Imai, H., Sakurai, T., Watanabe, T., et al. (2017) · Oncology · doi:10.1159/000481237 · Cited by 7 · see citing works
Seki, M., Ninomiya, E., Hayashi, K., Gotoh, H., Koga, R., Saiura, A., Yamada, K., Katori, M., Kato, Y., & Okamura, H. (2009) · Langenbeck s Archives of Surgery · doi:10.1007/s00423-009-0579-4 · Cited by 3 · see citing works
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- [23]James D Brierley MKG Wittekind Christian TNM Classification of Malignant nant Tumors 2018 8 New York, NY Wiley
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Miki, M., Masuda, A., Takenaka, M., Shiomi, H., Iemoto, T., Tsumura, H., Tsujimae, M., Toyama, H., Sofue, K., Ueshima, E., et al. (2024) · Journal of Gastroenterology · doi:10.1007/s00535-024-02149-0 · Cited by 11 · see citing works
Park, B. K., Koh, H. D., Won, S. Y., Cho, Y. S., Seo, J. H., An, C., & Park, S. (2023) · Journal of Gastrointestinal Oncology · doi:10.21037/jgo-22-863 · Cited by 10 · see citing works
“In three case series studies of localized main pancreatic duct structure without a detectable mass, 47–54% of cases were actually diagnosed with pancreatic cancer (31-33).”
Ren, H., Mori, N., Hirasawa, M., Hamada, S., Mugikura, S., Masamune, A., & Takase, K. (2021) · Journal of Clinical Imaging Science · doi:10.25259/jcis_158_2021 · Cited by 9 · see citing works
Fung, A., Zaheer, A., Porter, K. K., Bashir, M. R., Cash, B. D., Chiorean, E. G., Choi, Y., Ejaz, A. M., Gage, K. L., Russo, G. K., et al. (2025) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2025.08.037 · Cited by 4 · see citing works
Yamao, K., Takehara, Y., Ogawa, H., Nakahodo, J., Minami, R., Sagami, R., Nishikiori, H., Okita, M., Takahashi, H., Takada, Y., et al. (2025) · Pancreatology · doi:10.1016/j.pan.2025.06.003 · Cited by 3 · see citing works
Kaga, T., Noda, Y., Asano, M., Kawai, N., Kajita, K., Takai, Y., Ejima, F., Hyodo, F., Kato, H., Fukukura, Y., et al. (2024) · Magnetic Resonance in Medical Sciences · doi:10.2463/mrms.mp.2024-0046 · Cited by 2 · see citing works
Vullierme, M. (2024) · European Radiology · doi:10.1007/s00330-024-10905-2 · Cited by 2 · see citing works
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Kano, S., Gonoi, W., Nakaya, M., Inui, S., Nakai, Y., Masuoka, S., Masumoto, T., Minami, M., Gaballah, A. H., & Abe, O. (2026) · Radiographics · doi:10.1148/rg.250085 · Cited by 1 · see citing works
Ren, H., Mori, N., Mugikura, S., & Takase, K. (2021) · Abdominal Radiology · doi:10.1007/s00261-021-03346-8
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Radiologic Diagnosis of Pancreatic Cancer
Recht, H. S., & Fishman, E. K. (2023) · doi:10.1002/9781119876007.ch129
- Authors
- Kurita, A., Mori, Y., Someya, Y., Kubo, S., Azuma, S., Iwano, K., Ikeda, S., Okumura, R., & Yazumi, S.
- Affiliations
- Rakuwakai Otowa Hospital (JP)
- Kitano Hospital (JP)
- Corresponding author
- Kurita, Akira
- ORCID
- Venue
- Abdominal Radiology
- Published
- 2021-07-05
- Volume
- 46
- Issue
- 10
- Pages
- 4817-4827
- ISSN
- 2366-004X (ISSN-L)
- 2366-0058
- PMC
- PMC8435518
- OpenAlex
- W3177730269
- Cited by
- 13
- References
- 51
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 2
- FWCI
- 0.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Abdominal Radiology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › MRI in cancer diagnosis
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Keywords
- pancreatic ductal adenocarcinoma, early detection, diffusion-weighted imaging, high signal intensity, endoscopic ultrasound, pancreatic juice cytology, surgical resection, pancreatic cancer
- MeSH terms
- Humans, Magnetic Resonance Imaging, Pancreas, Pancreatic Neoplasms, Retrospective Studies, Carcinoma, Pancreatic Ductal
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