All research presented at ACG 2025 is strictly embargoed until 12:00 pm local Arizona Time, which aligns with Pacific Daylight Time (PDT)/3:00 pm ET on Sunday, October 26, 2025.
P0080 – Early Signs of Pancreas Adenocarcinoma Are Often Missed on Cross-Sectional Imaging: Results From a Multicenter Cohort Study
Sunday, October 26, 2025 | 3:30 PM – 7:00 PM PDT | Exhibit Hall
Author Insight from Benjamin Moy, MD
What’s new here and important for clinicians?
The complex developmental pattern of pancreatic ductal adenocarcinoma (PDAC) and challenges with detecting pancreatic lesions radiologically make early diagnosis of PDAC difficult. We evaluated the prevalence and type of abnormal findings on pre-diagnostic scans in patients later diagnosed with PDAC. While >20% of patients diagnosed with PDAC had a pre-diagnostic scan performed 3-36 months before diagnosis, most of these scans had no pancreas abnormalities noted. Despite this “negative” preceding scan, patients often presented at diagnosis with large tumors and over 90% had a discernible mass on imaging. Findings suggestive of PDAC such as ductal dilation and atrophy are uncommonly reported on pre-diagnostic scans. However, when present, they are more common than in non-PDAC patients and may suggest early signs of PDAC. In this cohort, the paucity of recognized abnormal findings on pre-diagnostic imaging highlights the suboptimal yield of cross-sectional imaging to identify early PDAC. These nuances can inform future research and clinical practice as physicians assess pathologic/radiologic findings and approach risk stratification and natural disease progression in these populations.
What do patients need to know?
Early diagnoses of PDAC are challenging given the nuanced diagnostic yield of cross-sectional imaging. Many patients diagnosed with PDAC often do not have a preceding scan indicating risk of developing PDAC. However, when focal pancreatic findings are noted, they occur more commonly in patients who eventually developed PDAC. In our study cohort, the paucity of abnormal findings on pre-diagnostic imaging demonstrates the challenges of cross-sectional imaging to identify early PDAC. Future studies are being undertaken to better understand the natural progression of PDAC, assess abnormal pathologic and radiologic findings, and elucidate the role of novel technologies for diagnostic interpretation and risk stratification.
Author Contact
Benjamin Moy, MD
McGaw Medical Center of Northwestern University
Chicago, IL
benjamin.moy [at] northwestern.edu
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