A multicentre comparative prospective blinded analysis of EUS and MRI for screening of pancreatic cancer in high-risk individuals
Open accessAbstract
Objective: Endoscopic ultrasonography (EUS) and MRI are promising tests to detect precursors and early-stage pancreatic ductal adenocarcinoma (PDAC) in high-risk individuals (HRIs). It is unclear which screening technique is to be preferred. We aimed to compare the efficacy of EUS and MRI in their ability to detect clinically relevant lesions in HRI. Design: Multicentre prospective study. The results of 139 asymptomatic HRI (>10-fold increased risk) undergoing first-time screening by EUS and MRI are described. Clinically relevant lesions were defined as solid lesions, main duct intraductal papillary mucinous neoplasms and cysts ≥10 mm. Results were compared in a blinded, independent fashion. Results: Two solid lesions (mean size 9 mm) and nine cysts ≥10 mm (mean size 17 mm) were detected in nine HRI (6%). Both solid lesions were detected by EUS only and proved to be a stage I PDAC and a multifocal pancreatic intraepithelial neoplasia 2. Of the nine cysts ≥10 mm, six were detected by both imaging techniques and three were detected by MRI only. The agreement between EUS and MRI for the detection of clinically relevant lesions was 55%. Of these clinically relevant lesions detected by both techniques, there was a good agreement for location and size. Conclusions: EUS and/or MRI detected clinically relevant pancreatic lesions in 6% of HRI. Both imaging techniques were complementary rather than interchangeable: contrary to EUS, MRI was found to be very sensitive for the detection of cystic lesions of any size; MRI, however, might have some important limitations with regard to the timely detection of solid lesions.
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Lorenzo, D., Rebours, V., Maire, F., Palazzo, M., Gonzalez, J., Vullierme, M., Aubert, A., Hammel, P. R., Lévy, P., & de Mestier, L. (2019) · World Journal of Gastroenterology · doi:10.3748/wjg.v25.i34.5082 · Cited by 25 · see citing works
Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic Cancer
Terada, S., Kikuyama, M., Kawaguchi, S., Kanemoto, H., Yokoi, Y., Kamisawa, T., Kuruma, S., Chiba, K., Honda, G., Horiguchi, S., et al. (2019) · Diagnostics · doi:10.3390/diagnostics9010015 · Cited by 21 · see citing works
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What should be known prior to performing EUS?
Dietrich, C., Arcidiacono, P., Braden, B., Burmeister, S., Carrara, S., Cui, X.-W., Leo, M. D., Dong, Y., Fusaroli, P., Gilja, O., et al. (2019) · Endoscopic Ultrasound · doi:10.4103/eus.eus_54_18 · Cited by 19 · see citing works
“Introduction Combining TUS or other cross-sectional imaging with EUS may provide complementary information, for example, in oncological staging, but also in gastric, biliary and endocrine diseases, cystic and solid pancreatic lesions, or idiopathic acute and chronic pancreatitis.[28-34] The topic was controversially d…”
BackgroundScreening for pancreatic cancer has the potential to save lives, but is it practical?
Mazer, B. L., Lee, J. W., Roberts, N. J., Chu, L. C. H., Lennon, A. M., Klein, A. P., Eshleman, J. R., Fishman, E. K., Canto, M. I., Goggins, M., et al. (2023) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2023.2217354 · Cited by 23 · see citing works
“Harinck and colleagues compared endoscopic ultrasound to magnetic resonance imaging in a screening study of 139 asymptomatic high-risk individuals [131].”
ResultCurrent Screening Strategies for Pancreatic Cancer
Vaněk, P., Urban, O., Zoundjiekpon, V., & Falt, P. (2022) · Biomedicines · doi:10.3390/biomedicines10092056 · Cited by 21 · see citing works
The Role of MR Imaging in Pancreatic Cancer.
Jha, P., Yeh, B. M., Zagoria, R., Collisson, E., & Wang, Z. (2018) · Magnetic Resonance Imaging Clinics of North America · doi:10.1016/j.mric.2018.03.004 · Cited by 18 · see citing works
Kumar, S., Saumoy, M., Oh, A., Schneider, Y., Brand, R., Chak, A., Ginsberg, G., Kochman, M., Canto, M., Goggins, M., et al. (2021) · Pancreas · doi:10.1097/mpa.0000000000001835 · Cited by 17 · see citing works
the Dutch Familial Pancreatic Cancer Surveillance Study Group, Overbeek, K. A., Cahen, D. L., Kamps, A., Konings, I. C. A. W., Harinck, F., Kuenen, M. A., Koerkamp, B. G., Besselink, M. G., van Eijck, C. H. J., et al. (2020) · Familial Cancer · doi:10.1007/s10689-020-00171-8 · Cited by 19 · see citing works
Self-citationShah, I., Silva-Santisteban, A., Germansky, K. A., Trindade, A., Raphael, K. L., Kushnir, V., Pawa, R., Mishra, G., Anastasiou, J., Inamdar, S., et al. (2023) · American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002314 · Cited by 15 · see citing works
“In a multicenter study of 139 high-risk individuals undergoing screening, 2 solid lesions (mean size 9 mm) were detected by EUS alone (23).”
Scholten, L., Latenstein, A. E. J., Aalfs, C. M., Bruno, M. J., Busch, O. R., Bonsing, B. A., Koerkamp, B. G., Molenaar, I. Q., Ubbink, D. T., van Hooft, J. E., et al. (2020) · United European Gastroenterology Journal · doi:10.1177/2050640620945534 · Cited by 15 · see citing works
“In some countries, individuals with a high risk of developing PDAC may enter a dedicated screening programme in a research setting.(9,10) Such a programme has also been introduced in The Netherlands.”
BackgroundSelf-citationInherited predisposition to pancreatic cancer
Hilfrank, K. J., Rustgi, S. D., & Kastrinos, F. (2021) · Seminars in Oncology · doi:10.1053/j.seminoncol.2021.02.006 · Cited by 3 · see citing works
Ishii, Y., Serikawa, M., Tsuboi, T., Kawamura, R., Tsushima, K., Nakamura, S., Hirano, T., Fukiage, A., Mori, T., Ikemoto, J., et al. (2021) · Diagnostics · doi:10.3390/diagnostics11020238 · Cited by 17 · see citing works
“[51] also reported that 11 mm and 7 mm solid lesions and nine cysts of 10 mm and above were found in nine patients (6%) in a comparative prospective trial of EUS and MRI detection rates for clinically relevant lesions at the first screening for 139 asymptomatic HRIs.”
BackgroundKurita, A., Mori, Y., Someya, Y., Kubo, S., Azuma, S., Iwano, K., Ikeda, S., Okumura, R., & Yazumi, S. (2021) · Abdominal Radiology · doi:10.1007/s00261-021-03199-1 · Cited by 13 · see citing works
Early detection of pancreatic cancer in the era of precision medicine
Ahmed, T. M., Kawamoto, S., Lopez-Ramirez, F., Yasrab, M., Hruban, R. H., Fishman, E. K., & Chu, L. C. H. (2024) · Abdominal Radiology · doi:10.1007/s00261-024-04358-w · Cited by 11 · see citing works
“MRI and EUS have been demonstrated to be particularly effective in tandem, with MRI being especially sensitive for cystic lesion and EUS for solid lesions [23].”
The role of endoscopic ultrasound in the detection of pancreatic lesions in high-risk individuals
Overbeek, K. A., Cahen, D. L., & Bruno, M. J. (2024) · Familial Cancer · doi:10.1007/s10689-024-00380-5 · Cited by 11 · see citing works
“The sensitivity of EUS to detect cystic lesions in high-risk individuals has been compared in a blinded fashion in one study by Harinck et al. They compared baseline EUS to baseline MRI/MRCP in 139 high-risk individuals, and found a sensitivity for cystic lesions of 39% for EUS and 90% for MRI [87].”
Self-citationAspects and outcomes of surveillance for individuals at high-risk of pancreatic cancer
Bogdanski, A. M., van Hooft, J. E., Boekestijn, B., Bonsing, B. A., Wasser, M. N. J. M., Klatte, D. C. F., & van Leerdam, M. E. (2024) · Familial Cancer · doi:10.1007/s10689-024-00368-1 · Cited by 12 · see citing works
Kikuyama, M., Nakahodo, J., Honda, G., Suzuki, M., Horiguchi, S., Chiba, K., Tabata, H., Ome, Y., Uemura, S., Kawamoto, Y., et al. (2023) · Pancreatology · doi:10.1016/j.pan.2023.03.002 · Cited by 10 · see citing works
COVID-19 related pancreatic cancer surveillance disruptions amongst high-risk individuals
Katona, B. W., Mahmud, N., Dbouk, M. H., Ahmad, N. A., Chhoda, A., Dudley, B., Hayat, U., Kwon, R. S., Lee, L., Rustgi, A. K., et al. (2021) · Pancreatology · doi:10.1016/j.pan.2021.04.005 · Cited by 12 · see citing works
de Mestier, L., Müller, M., Cros, J. F., Vullierme, M., Vernerey, D., Maire, F., Dokmak, S., Rebours, V., Sauvanet, A., Lévy, P., et al. (2019) · United European Gastroenterology Journal · doi:10.1177/2050640618824910 · Cited by 13 · see citing works
Challenges of early detection of pancreatic cancer
Shen, M. J., Jamali, A., & Katona, B. W. (2025) · Journal of Clinical Investigation · doi:10.1172/jci191942 · Cited by 22 · see citing works
“This was supported by a 2022 study from the Netherlands, where EUS was superior to MRI/MRCP for the detection of solid lesions, whereas MRI/MRCP outperformed EUS in detecting cystic lesions, primarily driven by increased detection of sub-centimeter-sized cysts (15).”
Ji, Y.-B., Săftoiu, A., Udriștoiu, A., Gruionu, L., Gheorghe, E. C., Gruionu, G., Ramesh, J., Wilcox, C. M., & Varadarajulu, S. (2025) · Endoscopy · doi:10.1055/a-2701-6530 · Cited by 10 · see citing works
Huang, C., Hecht, E. M., Soloff, E. V., Tiwari, H. A., Bhosale, P., Dasayam, A., Galgano, S. J., Kambadakone, A., Kulkarni, N. M., Le, O., et al. (2024) · American Journal of Roentgenology · doi:10.2214/ajr.24.31151 · Cited by 13 · see citing works
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Current Status of Endoscopic Ultrasound Techniques for Pancreatic Neoplasms
Nakai, Y., Takahara, N., Mizuno, S., Kogure, H., & Koike, K. (2019) · Clinical Endoscopy · doi:10.5946/ce.2019.025 · Cited by 10 · see citing works
“Both EUS and MRI had a role in the screening program for high-risk individuals (Table 1).(39) While MRI can detect small pancreatic cysts, EUS is sensitive for the detection of small solid lesions.”
BackgroundFarrell, J. (2018) · Endoscopic Ultrasound · doi:10.4103/eus.eus_49_18 · Cited by 12 · see citing works
“317 ENDOSCOPIC ULTRASOUND / VOLUME 7 | ISSUE 5 / SEPTEMBER-OCTOBER 2018 PanIN lesions.[22,23] There are no specific fluid-based or imaging (e.”
BackgroundCost-Effectiveness Analysis of Screening for Pancreatic Cancer Among High-Risk Populations
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Pancreatic Cancer Surveillance: Who, When, and How
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Pancreatic Cancer Surveillance and Novel Strategies for Screening
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- Authors
- 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., Wagner, A., Sijmons, R. H., Biermann, K., van Eijck, C. H., Gouma, D. J., Dijkgraaf, M. G. W., Fockens, P., & Bruno, M. J.
- Affiliations
- Erasmus MC (NL)
- The Netherlands Cancer Institute (NL)
- Department of Gastroenterology and Hepatology, Amsterdam Medical Center, University Medical Center Amsterdam, Amsterdam, The Netherlands
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Amsterdam University Medical Centers (NL)
- Radboud University Medical Center (NL)
- University Medical Center Groningen (NL)
- Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Corresponding author
- Harinck, F
- ORCID
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2015-05-18
- Volume
- 65
- Issue
- 9
- Pages
- 1505-1513
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- OpenAlex
- W1907808487
- Cited by
- 185
- References
- 0
- Citations by year
- 2026: 13 · 2025: 6 · 2024: 16 · 2023: 16 · 2022: 21 · 2021: 19 · 2020: 16 · 2019: 23 · 2018: 18 · 2017: 19 · 2016: 15 · 2015: 3
- FWCI
- 7.97
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- other-oa
- Locations
- Gut (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- ZonMw (120520016)
- 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 cancer screening, endoscopic ultrasound, magnetic resonance imaging, pancreatic ductal adenocarcinoma, high-risk individuals, intraductal papillary mucinous neoplasm, pancreatic cysts, pancreatic intraepithelial neoplasia, solid pancreatic lesions, diagnostic agreement, early cancer detection
- MeSH terms
- Adult, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Netherlands, Pancreas, Pancreatic Cyst, Pancreatic Neoplasms, Prospective Studies, Cohort Studies, Endosonography, Carcinoma, Pancreatic Ductal, Early Detection of Cancer, Comparative Effectiveness Research, Asymptomatic Diseases
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