Effectiveness of Focal Pancreatic Parenchymal Atrophy in Diagnosing High-Grade Pancreatic Intraepithelial Neoplasia/Carcinoma in Situ

To improve the poor prognosis of pancreatic ductal adenocarcinoma (PDAC), diagnosis early-stage PDAC is essential. In particular, high-grade intraepithelial neoplasia/carcinoma in situ (HG-PanIN/CIS) best option. However, it almost impossible to directly observe HG-PanIN/CIS. Thus, identifying a secondary imaging finding due disorder important. Focal parenchymal atrophy (FPPA) and hypoechoic area have been reported as preferred signs. We studied 50 patients clarify effectiveness FPPA diagnosing Most had opportunity undergo further examination presence cyst. Among patients, 23 (46%) positive results for serial pancreatic-juice aspiration cytologic (SPACE), which has high sensitivity specificity PADC; 20 (87.0%) underwent surgery resect part including FPPA. Distal pancreatectomy pancreatoduodenectomy were performed 19 one patient, respectively. 13 (65%) histopathological revealed HG-PanIN/CIS epithelium resected specimens. could indicate HG-PanIN/CIS, but not satisfactorily. One factors unsatisfactory might be difficulty head area. On other hand, cyst, especially FPPA, lead The size cyst does affect