Pancreatic MRI Findings in High-Risk Individuals Compared With Matched Average-Risk Individuals

Area of Science:

• Oncology
• Radiology
• Genetics

Background:

• Pancreatic ductal adenocarcinoma (PDAC) screening is crucial for high-risk individuals (HRI).
• Magnetic Resonance Imaging (MRI) is a key screening tool that often detects pancreatic cystic lesions (PCLs).
• Limited comparative data exists on PCLs between HRI and average-risk individuals (ARI).

Purpose of the Study:

• To quantify and characterize differences in PCLs identified via MRI/MRCP between HRI and ARI.
• To compare PCL prevalence and characteristics in specific HRI subgroups (Familial Pancreatic Cancer and pathogenic germline variants).

Main Methods:

• Retrospective analysis of 317 HRI and 634 age-, sex-, and race-matched ARI who underwent MRI/MRCP.
• Analysis of demographics, genetic factors, and baseline MRI/MRCP findings.
• Statistical comparison of PCL prevalence and characteristics between HRI and ARI groups, including subgroups.

Main Results:

• HRIs were significantly more likely to have PCLs than ARIs (50.8% vs. 25.7%, P<0.001).
• Familial Pancreatic Cancer (FPC) HRI had a higher PCL prevalence than pathogenic germline variant (PGV) HRI (54.1% vs. 44.4%, P=0.049).
• PCLs in HRIs were smaller on average than in ARIs (7.4 mm vs. 10.8 mm, P=0.002), with no difference in worrisome features.

Conclusions:

• PCLs are more prevalent in HRI compared to matched ARI, but are generally smaller and appear low-risk.
• Further longitudinal studies are needed to ascertain if the higher PCL prevalence in HRI correlates with an increased risk of malignancy or is due to enhanced detection.
• The findings highlight the importance of tailored surveillance strategies for HRI undergoing pancreatic cancer screening.