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Fam Cancer. 2018 Jan;17(1):101-111. doi: 10.1007/s10689-017-0057-z.

Development of a high risk pancreatic screening clinic using 3.0 T MRI.

Author information

1
Greater Midwest Pancreatic Cancer Screening Program, Department of Surgery, The Medical College of Wisconsin, Milwaukee, WI, USA.
2
Greater Midwest Pancreatic Cancer Screening Program, Department of Radiology, The Medical College of Wisconsin, Milwaukee, WI, USA.
3
Greater Midwest Pancreatic Cancer Screening Program, Department of Gastroenterology, The Medical College of Wisconsin, Milwaukee, WI, USA.
4
Greater Midwest Pancreatic Cancer Screening Program, Department of Surgery, The Medical College of Wisconsin, Milwaukee, WI, USA. stsai@mcw.edu.

Abstract

Selective screening for pancreatic cancer (PC) has been proposed. We describe the establishment of a comprehensive multidisciplinary screening program using 3.0 T MRI. Criteria for screening included the presence of PC in: ≥ 2 first degree relatives (FDR), 1 FDR and 1 s degree relative (SDR), ≥ 3 any degree relatives (ADR), or any known hereditary cancer syndrome with increased PC risk. Imaging with 3.0 T MRI was performed routinely and endoscopic ultrasound was used selectively. Screening was completed in 75 patients (pts). Hereditary cancer syndromes were present in 42 (56%) of the 75 pts: BRCA2 (18), ATM (8), BRCA1 (6), CDKN2A (4), PALB2 (3), Lynch (2), and Peutz-Jeghers (1). A family history of PC was present in ≥ 2 FDR in 12 (16%) pts, 1 FDR and 1 SDR in 5 (7) pts, and ≥ 3 ADR in 16 (21%) pts. Of the 65 pts who received screening MRI, 28 (43%) pts had pancreatic cystic lesions identified, including 1 (1%) patient in whom a cholangiocarcinoma was diagnosed as well. No patient underwent surgical resection. Using a 3.0 T MRI to screen patients at high risk for developing PC identified radiographic abnormalities in 43% of patients, which were stable on subsequent surveillance. Specific guidelines for the frequency of surveillance and indications for surgery remain areas of active investigation as the global experience with high risk screening continues to mature.

KEYWORDS:

Familial pancreatic cancer; High risk; Pancreas cancer screening

PMID:
29101607
DOI:
10.1007/s10689-017-0057-z
[Indexed for MEDLINE]

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