1. Early Detection of Pancreatic Cancer: Opportunities and Challenges
Aatur D. Singhi, Eugene J. Koay, Suresh T. Chari, Anirban Maitra 
Gastroenterology 
Volume 156, Issue 7, Pages (May 2019)
DOI: /j.gastro
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2. Figure 1
The pathology of IPMNs. The macroscopic and microscopic features of IPMNs are typically characterized by involvement of the main pancreatic duct, branch duct (shown here), or both. IPMNs are composed of mucinous epithelium that may be either flat or papillary in appearance. Based on the degree of cytoarchitectural atypia, IPMNs can be classified with low-grade or high-grade dysplasia. The most important prognosticator, however, is the absence or presence of an associated invasive PDAC.
Gastroenterology  , DOI: ( /j.gastro )
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3. Figure 2
Distribution of glycemic status based on fasting blood glucose levels in a population-based PDAC cohort (N = 219).
Gastroenterology  , DOI: ( /j.gastro )
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4. Figure 3
Common imaging modalities for PDAC, including (A) EUS, (B) CT, and (C) MRI. Each image shows a patient with an approximately 2-cm lesion in the body of the pancreas. Each modality has advantages and disadvantages for the purposes of early detection of PDAC. A few practical considerations are enumerated.
Gastroenterology  , DOI: ( /j.gastro )
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5. Figure 4
The future of PDAC early detection. Currently, the majority of PDACs are diagnosed at a late stage of their natural history, when they are symptomatic, if not surgically unresectable. Individuals with a family history or with cystic lesions represent high-risk cohorts that can be entered into surveillance programs, but they are only a subset of patients who develop PDAC. Determination of sporadic risk will require multiple input parameters (polygenic risk score, BMI, smoking history, other variables) but has the potential to affect the largest subset of individuals in the general population. Surveillance and diagnosis of asymptomatic PDAC in longitudinally monitored high-risk cohorts will require biomarkers with exquisite sensitivity and specificity to avoid the perils of false negatives and overdiagnosis, respectively. Imaging studies, by using a bevy of localization modalities discussed in the text, represents the penultimate step before an intervention such as surgery for removing a potentially “curable” early PDAC.
Gastroenterology  , DOI: ( /j.gastro )
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6. Aatur D. Singhi
Gastroenterology  , DOI: ( /j.gastro )
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7. Eugene J. Koay
Gastroenterology  , DOI: ( /j.gastro )
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8. Suresh T. Chari
Gastroenterology  , DOI: ( /j.gastro )
Copyright © 2019 AGA Institute Terms and Conditions

9. Anirban Maitra
Gastroenterology  , DOI: ( /j.gastro )
Copyright © 2019 AGA Institute Terms and Conditions