Role of endoscopic ultrasonography or magnetic resonance imaging for screening of pancreatic cancer in low-risk individuals

doi:10.5306/wjco.v16.i11.112030

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Nov 24, 2025 (publication date) through Nov 21, 2025

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World Journal of Clinical Oncology

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2218-4333

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Clin Oncol. Nov 24, 2025; 16(11): 112030
Published online Nov 24, 2025. doi: 10.5306/wjco.v16.i11.112030

Role of endoscopic ultrasonography or magnetic resonance imaging for screening of pancreatic cancer in low-risk individuals

Wei-Chen Lin, Lo-Yip Yu, Yang-Che Kuo, Chen-Wang Chang, Horng-Yuan Wang, Shou-Chuan Shih, Ching-Wei Chang, Hsiang-Hung Lin, Yi-Hsueh Chan, Ying-Chun Lin, Kuang-Chun Hu

Wei-Chen Lin, Lo-Yip Yu, Yang-Che Kuo, Chen-Wang Chang, Horng-Yuan Wang, Shou-Chuan Shih, Ching-Wei Chang, Kuang-Chun Hu, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 104217, Taiwan

Wei-Chen Lin, Lo-Yip Yu, Yang-Che Kuo, Shou-Chuan Shih, Kuang-Chun Hu, Healthy Evaluation Center, MacKay Memorial Hospital, Taipei 104217, Taiwan

Wei-Chen Lin, Lo-Yip Yu, Yang-Che Kuo, Chen-Wang Chang, Horng-Yuan Wang, Shou-Chuan Shih, Ching-Wei Chang, Kuang-Chun Hu, MacKay Junior College of Medicine, Nursing and Management, Taipei 112021, Taiwan

Wei-Chen Lin, Chen-Wang Chang, Horng-Yuan Wang, Shou-Chuan Shih, Ching-Wei Chang, Kuang-Chun Hu, College of Medicine, MacKay Medical University, New Taipei 252005, Taiwan

Hsiang-Hung Lin, Yi-Hsueh Chan, Dianthus Internal Medicine Clinic Minquan, Dianthus Medical Group, Taipei 114067, Taiwan

Ying-Chun Lin, Department of Anesthesia, MacKay Memorial Hospital, Taipei 104217, Taiwan

Ying-Chun Lin, Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 106319, Taiwan

Author contributions: Lin WC and Hu KC wrote the manuscript and performed the acquisition of subjects data, analysis and interpretation of data; Yu LY, Kuo YC, Lin HH, Chan YH, and Hu KC participated in the data curation; Lin YC and Hu KC participated in the formal analysis; Lin WC and Lin HH contributed to the methodology; Yu LY, Kuo YC, Chang CW, Wang HY, Shih SC, and Chang CW contributed to the visualization; Chang CW, Wang HY, Chang CW, and Shih SC contributed to the supervision; Lin WC participated in the original manuscript drafting; Lin HH, Lin YC, and Hu KC participated in the manuscript review and editing; Hu KC was responsible for study concept and design, coordination and correction of the writing of the manuscript; all authors have read and agreed to the published version of the manuscript.

Institutional review board statement: This study was approved by the Ethics Committee of MacKay Memorial Hospital (approval No. 25MMHIS129e).

Informed consent statement: All datasets were fully anonymized. Ethical review and approval were waived for this study.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: No additional data are available.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Kuang-Chun Hu, MD, PhD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mackay Memorial Hospital, No. 92 Section 2, Chungshan North Road, Taipei 104217, Taiwan. mimiandbear2001@yahoo.com.tw

Received: July 16, 2025
Revised: August 26, 2025
Accepted: October 17, 2025
Published online: November 24, 2025
Processing time: 128 Days and 14.9 Hours

Abstract

BACKGROUND

Magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS) are recommended in combination for screening pancreatic cancer in high-risk individuals. However, in clinical practice, MRI and EUS are increasingly utilized for pancreatic surveillance during routine health examinations.

AIM

To investigate the feasibility of these imaging modalities for screening in low-risk individuals.

METHODS

This retrospective study included patients at low risk for pancreatic cancer who underwent MRI or EUS at two health evaluation centers between March 2019 and December 2024. Basic characteristics, laboratory data, and imaging results were collected.

RESULTS

A total of 3364 low-risk individuals underwent pancreatic screening: 1553 (46.1%) received MRI, and 1811 underwent EUS. No significant differences were observed in age or sex distribution between the groups. In imaging screening, EUS demonstrated a higher detection rate of abnormal pancreatic lesions (12.8% vs 2.6%; P < 0.001). MRI detected more cystic lesions than did EUS (P < 0.001). EUS identified smaller nodular lesions compared to MRI (9.2 mm vs 18.0 mm; P = 0.044). The MRI group had a higher number of confirmed intraductal papillary mucinous neoplasms (P = 0.031), whereas the EUS group identified more suspected branch-duct intraductal papillary mucinous neoplasms (P < 0.001). Pancreatic adenocarcinoma was found in three patients (0.08%), with no significant difference in detection rates between EUS and MRI (0.11% vs 0.06%; P = 0.656).

CONCLUSION

In low-risk individuals, MRI and EUS offer comparable effectiveness for pancreatic cancer surveillance. The choice of imaging strategy for health evaluation depends on cost considerations and degree of invasiveness.

Keywords: Endoscopic ultrasonography; Low-risk individuals; Pancreatic cancer; Magnetic resonance imaging; Screening

Core Tip: Screening is not recommended for average-risk individuals due to the low incidence of pancreatic cancer. However, in practice, magnetic resonance imaging and endoscopic ultrasonography are increasingly used for pancreatic surveillance during health examinations. This study demonstrated the comparable effectiveness of both imaging modalities in detecting pancreatic adenocarcinoma in health evaluation centers. The implementation of broader screening strategies for low-risk individuals should be carefully considered in light of the age-related increases in risk factors, procedural invasiveness, and associated costs.