Current Role of Endoscopic Ultrasonography in the Early Detection of Pancreatic Cancer: Recognition of Indirect Imaging Findings and Diagnostic Strategy
Abstract
Pancreatic cancer remains one of the most lethal malignancies because most patients are diagnosed at an advanced stage. Endoscopic ultrasonography (EUS) has emerged as a key modality for early detection owing to its high spatial resolution and non-invasiveness. In particular, EUS can identify indirect imaging findings associated with pancreatic carcinoma in situ and very early stage pancreatic cancer, including focal main pancreatic duct stenosis, focal pancreatic parenchymal atrophy, periductal hypoechoic changes, and parenchymal heterogeneity, which often precede the formation of detectable masses. EUS also facilitates pathological confirmation through pancreatic juice cytology and tissue sampling. Furthermore, advances in contrast-enhanced imaging, elastography, microvascular imaging, and artificial intelligence have expanded the diagnostic potential of EUS. This review summarizes the current role of EUS in the early detection of pancreatic cancer, focusing on indirect imaging findings, diagnostic strategies, and future perspectives.
Related
- Graph Neural Network Modelling of Pre-Diagnostic Serum Proteomics for Pancreatic Cancer Detection
- Early detection and interception in hepato-pancreatic-biliary cancers: endoscopic imaging, liquid biopsy, and emerging molecular biomarkers
- A Gastric Glomus Tumor Diagnosed Preoperatively Using Contrast-enhanced Harmonic Endoscopic Ultrasonography and Endoscopic Ultrasonography-guided Fine Needle Aspiration
- Diagnostic Performance and Safety of Endoscopic Ultrasound-Guided Fine-Needle Biopsy (EUS-FNB) Under Conscious Sedation for Small Solid Pancreatic Lesions (<20 mm): A Retrospective Cohort Study
- Macroscopic Tissue Integrity and Histological Diagnostic Yield During Endoscopic Ultrasound-Guided Tissue Acquisition for Solid Pancreatic Lesions
BibTeX
@article{hanada2026current,
title = {{Current Role of Endoscopic Ultrasonography in the Early Detection of Pancreatic Cancer: Recognition of Indirect Imaging Findings and Diagnostic Strategy}},
author = {Keiji Hanada},
journal = {Internal Medicine},
year = {2026},
month = aug,
doi = {10.2169/internalmedicine.8054-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_8054-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Current Role of Endoscopic Ultrasonography in the Early Detection of Pancreatic Cancer: Recognition of Indirect Imaging Findings and Diagnostic Strategy
AU - Keiji Hanada
PY - 2026
DA - 2026/08/08
JO - Internal Medicine
DO - 10.2169/internalmedicine.8054-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_8054-26/_article
AB - Pancreatic cancer remains one of the most lethal malignancies because most patients are diagnosed at an advanced stage. Endoscopic ultrasonography (EUS) has emerged as a key modality for early detection owing to its high spatial resolution and non-invasiveness. In particular, EUS can identify indirect imaging findings associated with pancreatic carcinoma in situ and very early stage pancreatic cancer, including focal main pancreatic duct stenosis, focal pancreatic parenchymal atrophy, periductal hypoechoic changes, and parenchymal heterogeneity, which often precede the formation of detectable masses. EUS also facilitates pathological confirmation through pancreatic juice cytology and tissue sampling. Furthermore, advances in contrast-enhanced imaging, elastography, microvascular imaging, and artificial intelligence have expanded the diagnostic potential of EUS. This review summarizes the current role of EUS in the early detection of pancreatic cancer, focusing on indirect imaging findings, diagnostic strategies, and future perspectives.
SN - 1349-7235
SN - 0918-2918
ER -