Early features of pancreatic cancer on magnetic resonance imaging (MRI): a case–control study

Magnetic resonance imaging has been recommended as a primary imaging modality among high-risk individuals undergoing screening for pancreatic cancer. We aimed to delineate potential precursor lesions for pancreatic cancer on MR imaging. We conducted a case–control study at Kaiser Permanente Southern California (2008–2018) among patients that developed pancreatic cancer who had pre-diagnostic MRI examinations obtained 2–36 months prior to cancer diagnosis (cases) matched 1:2 by age, gender, race/ethnicity, contrast status and year of scan (controls). Patients with history of acute/chronic pancreatitis or prior pancreatic surgery were excluded. Images underwent blind review with assessment of a priori defined series of parenchymal and ductal features. We performed logistic regression to assess the associations between individual factors and pancreatic cancer. We further assessed the interaction among features as well as performed a sensitivity analysis stratifying based on specific time-windows (2–3 months, 4–12 months, 13–36 months prior to cancer diagnosis). We identified 141 cases (37.9