Cited by 185Pancreatic and Hepatic Oncology ResearchMRI in cancer diagnosisPancreatitis Pathology and Treatment

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A multicentre comparative prospective blinded analysis of EUS and MRI for screening of pancreatic cancer in high-risk individuals

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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·2016·Gut

DOI 10.1136/gutjnl-2014-308008

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Abstract

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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Sagami, R., Yamao, K., Nakahodo, J., Minami, R., Tsurusaki, M., Murakami, K., & Amano, Y. (2021) · Cancers · doi:10.3390/cancers13050945 · Cited by 45
Perspectives on the combination of radiotherapy and targeted therapy with DNA repair inhibitors in the treatment of pancreatic cancer
Yang, S., Kuo, T., Wu, H., Guo, J., Hsu, C., Hsu, C., Tien, Y., Yeh, K., Cheng, A., & Kuo, S. (2016) · World Journal of Gastroenterology · doi:10.3748/wjg.v22.i32.7275 · Cited by 33
The Role of Endoscopic Ultrasonography in the Diagnosis and Staging of Pancreatic Cancer
Zakaria, A., Al-Share, B. A., Klapman, J. B., & Dam, A. N. (2022) · Cancers · doi:10.3390/cancers14061373 · Cited by 34
“EUS detected more solid lesions than MRI/MRCP, while MRI/MRCP was more sensitive to cystic lesions of any size [77,78].”
Background
Surveillance for pancreatic cancer in high‐risk individuals
Konings, I. C. A. W., Canto, M. I., Almario, J. A., Harinck, F., Saxena, P., Lucas, A. L., Kastrinos, F., Whitcomb, D. C., Brand, R. E., Lachter, J., et al. (2019) · BJS Open · doi:10.1002/bjs5.50180 · Cited by 36
Self-citation
Surveillance for neoplasia in the pancreas
Overbeek, K. A., Cahen, D. L., Canto, M. I., & Bruno, M. J. (2016) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2016.10.013 · Cited by 28
Self-citation
Surveillance of high-risk individuals for pancreatic cancer with EUS and MRI: A meta-analysis.
Kogekar, N., Diaz, K., Weinberg, A., & Lucas, A. (2020) · Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · doi:10.26226/morressier.5ebc4ac6ffea6f735881a3f6 · Cited by 28
Familial Pancreatic Cancer and the Future of Directed Screening
Welinsky, S., & Lucas, A. L. (2017) · Gut and Liver · doi:10.5009/gnl16414 · Cited by 33
Diagnostic utility of endoscopic ultrasonography-elastography in the evaluation of solid pancreatic masses: a meta-analysis and systematic review.
Lu, Y., Chen, L., Li, C.-J., Chen, H.-L., & Chen, J. (2017) · Medical ultrasonography · doi:10.11152/mu-987 · Cited by 28
“A previous study has shown that, magnetic resonance imaging (MRI) was very sensitive to detect pancreatic cystic lesions, while endoscopic ultrasonography (EUS) showed its superiority in solid lesions [3].”
Background
Pre-therapy PET-based voxel-wise dosimetry prediction by characterizing intra-organ heterogeneity in PSMA-directed radiopharmaceutical theranostics
Xue, S., Gafita, A., Zhao, Y. S., Mercolli, L., Cheng, F., Rauscher, I., D’Alessandria, C., Seifert, R., Afshar‐Oromieh, A., Rominger, A., et al. (2024) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-024-06737-3 · Cited by 31
Familial Pancreatic Cancer
Saba, H., & Goggins, M. (2022) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2022.06.006 · Cited by 20
American Society for Gastrointestinal Endoscopy guideline on screening for pancreatic cancer in individuals with genetic susceptibility: methodology and review of evidence
Calderwood, A. H., Sawhney, M., Thosani, N. C., Rebbeck, T. R., Wani, S. B., Canto, M. I., Fishman, D. S., Golan, T., Hidalgo, M. M., Kwon, R. S., et al. (2022) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2021.12.002 · Cited by 30
Non-branched microcysts of the pancreas on MR imaging of patients with pancreatic tumors who had pancreatectomy may predict the presence of pancreatic intraepithelial neoplasia (PanIN): a preliminary study
Vullierme, M., Menassa, L., Couvelard, A., Rebours, V., Maire, F., Ibrahim, T., Cros, J. F., Ruszniewski, P. B., Sauvanet, A., Lévy, P., et al. (2019) · European Radiology · doi:10.1007/s00330-019-06154-3 · Cited by 23
Chronic pancreatitis changes in high-risk individuals for pancreatic ductal adenocarcinoma
Thiruvengadam, S. S., Chuang, J., Huang, R. J., Girotra, M., & Park, W. G. (2018) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2018.08.029 · Cited by 26
Second primary pancreatic ductal carcinoma in the remnant pancreas after pancreatectomy for pancreatic ductal carcinoma: High cumulative incidence rates at 5 years after pancreatectomy.
Ishida, J., Toyama, H., Matsumoto, I., Asari, S., Goto, T., Terai, S., Nanno, Y., Yamashita, A., Mizumoto, T., Ueda, Y., et al. (2016) · Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · doi:10.1016/j.pan.2016.05.003 · Cited by 23
Screening for pancreatic cancer in high-risk individuals using MRI: optimization of scan techniques to detect small lesions
Boekestijn, B., Feshtali, S., Vasen, H. F. A., van Leerdam, M. E., Bonsing, B. A., Mieog, J. S. D., & Wasser, M. N. J. M. (2024) · Familial Cancer · doi:10.1007/s10689-024-00394-z · Cited by 20
Association of Glycated Hemoglobin Levels With Risk of Pancreatic Cancer
Wu, B. U., Butler, R. K., Lustigova, E., Lawrence, J. M., & Chen, W. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.4945 · Cited by 26
EUS and related technologies for the diagnosis and treatment of pancreatic disease: research gaps and opportunities—Summary of a National Institute of Diabetes and Digestive and Kidney Diseases workshop
Lee, L. S., Andersen, D., Ashida, R., Brugge, W., Canto, M., Chang, K., Chari, S., DeWitt, J., Hwang, J., Khashab, M., et al. (2017) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2017.08.006 · Cited by 22
Role of endoscopic ultrasound in the screening and follow-up of high-risk individuals for familial pancreatic cancer
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
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
Endoscopic Ultrasound and Related Technologies for the Diagnosis and Treatment of Pancreatic Disease - Research Gaps and Opportunities: Summary of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop
Lee, L. S., Andersen, D., Ashida, R., Brugge, W., Canto, M., Chang, K., Chari, S., DeWitt, J., Hwang, J., Khashab, M., et al. (2017) · Pancreas · doi:10.1097/mpa.0000000000000936 · Cited by 21
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
“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…”
Background
Screening 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 24
“Harinck and colleagues compared endoscopic ultrasound to magnetic resonance imaging in a screening study of 139 asymptomatic high-risk individuals [131].”
Result
Current Screening Strategies for Pancreatic Cancer
Vaněk, P., Urban, O., Zoundjiekpon, V., & Falt, P. (2022) · Biomedicines · doi:10.3390/biomedicines10092056 · Cited by 21
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
Threshold Analysis of the Cost-effectiveness of Endoscopic Ultrasound in Patients at High Risk for Pancreatic Ductal Adenocarcinoma
Kumar, S., Saumoy, M., Oh, A., Schneider, Y., Brand, R. E., Chak, A., Ginsberg, G. G., Kochman, M. L., Canto, M. I., Goggins, M., et al. (2021) · Pancreas · doi:10.1097/mpa.0000000000001835 · Cited by 24
Patient-reported burden of intensified surveillance and surgery in high-risk individuals under pancreatic cancer surveillance
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
Self-citation
Pancreatic Cancer Screening for At-Risk Individuals (Pancreas Scan Study): Yield, Harms, and Outcomes From a Prospective Multicenter Study
Shah, 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
“In a multicenter study of 139 high-risk individuals undergoing screening, 2 solid lesions (mean size 9 mm) were detected by EUS alone (23).”
Prophylactic total pancreatectomy in individuals at high risk of pancreatic ductal adenocarcinoma (PROPAN): systematic review and shared decision‐making programme using decision tables
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
“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-citation
Inherited 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
Role of Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Pancreatic Cancer
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
“[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.”
Background
High signal intensity on diffusion-weighted magnetic resonance images is a useful finding for detecting early-stage pancreatic cancer
Kurita, 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
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 12
“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
“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-citation
Aspects 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
Pancreatic duct epithelial malignancy suggested by large focal pancreatic parenchymal atrophy in cystic diseases of the pancreas
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
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
Appropriateness of pancreatic resection in high‐risk individuals for familial pancreatic ductal adenocarcinoma: a patient‐level meta‐analysis and proposition of the Beaujon score
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 14
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 24
“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).”
Prospective clinical validation of a novel artificial intelligence system for real-time detection of solid pancreatic masses during endoscopic ultrasonography
Bang, J. Y., Săftoiu, A., Udriștoiu, Ș., Gruionu, L. G., Gheorghe, E. C., Gruionu, G., Ramesh, J., Wilcox, C. M., & Varadarajulu, S. (2025) · Endoscopy · doi:10.1055/a-2701-6530 · Cited by 10
Imaging for Early Detection of Pancreatic Ductal Adenocarcinoma: Updates and Challenges in the Implementation of Screening and Surveillance Programs
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
Carcinoma in situ of the pancreas with pancreatic duct stricture persistent for 4 years diagnosed by serial pancreatic juice aspiration cytologic examination (SPACE)
Kuruma, S., Kikuyama, M., Chiba, K., Yoshimoto, K., Kamisawa, T., Honda, G., Horiguchi, S., & Nakahodo, J. (2019) · Clinical Journal of Gastroenterology · doi:10.1007/s12328-019-01065-8 · Cited by 10
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
“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.”
Background
Intraductal papillary mucinous neoplasm to pancreas ductal adenocarcinoma sequence and pancreas cancer screening
Farrell, J. (2018) · Endoscopic Ultrasound · doi:10.4103/eus.eus_49_18 · Cited by 12
“317 ENDOSCOPIC ULTRASOUND / VOLUME 7 | ISSUE 5 / SEPTEMBER-OCTOBER 2018 PanIN lesions.[22,23] There are no specific fluid-based or imaging (e.”
Background
Cost-Effectiveness Analysis of Screening for Pancreatic Cancer Among High-Risk Populations
Peters, M. L. B., Eckel, A. L., Seguin, C. L., Davidi, B., Howard, D. H., Knudsen, A. B., & Pandharipande, P. V. (2023) · JCO Oncology Practice · doi:10.1200/op.23.00495 · Cited by 22
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
The importance of a well-structured pancreatic screening program for familial and hereditary pancreatic cancer
Vasen, H. F. A. (2017) · Familial Cancer · doi:10.1007/s10689-017-0066-y · Cited by 10
Pancreatic Cancer Surveillance and Novel Strategies for Screening
Dudley, B., & Brand, R. E. (2021) · Gastrointestinal Endoscopy Clinics of North America · doi:10.1016/j.giec.2021.08.008 · Cited by 10
Usefulness of non-contrast MR imaging in distinguishing pancreatic ductal adenocarcinoma from focal pancreatitis.
Lee, J. H., Min, J., Kim, Y. K., Cha, D., Lee, J.-S., Park, H., & Ahn, S. (2019) · Clinical imaging · doi:10.1016/j.clinimag.2019.02.013 · Cited by 8

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)
Amsterdam University Medical Centers (NL)
University Medical Center Groningen (NL)
Radboud University Medical Center (NL)
Corresponding author: Harinck, F
ORCID: Harinck, F
Konings, I C A W
Poley, J W
van Hooft, J E
van Dullemen, H M
Hermans, J J
Aalfs, C M
Wagner, A
Sijmons, R H
van Eijck, C H
Dijkgraaf, M G W
Fockens, P
Bruno, M J
Venue: Gut
Publisher: BMJ
Published: 2015-05-18
Volume: 65
Issue: 9
Pages: 1505-1513
ISSN: 0017-5749 (ISSN-L)
1468-3288
DOI: 10.1136/gutjnl-2014-308008
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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A multicentre comparative prospective blinded analysis of EUS and MRI for screening of pancreatic cancer in high-risk individuals

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