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Pioneering MRI Technique Detects Pre-Malignant Pancreatic Lesions for The First Time

By MedImaging International staff writers
Posted on 16 Dec 2024

Image: MRI microscopy of mouse and human pancreas with respective histology demonstrating ability of DTI maps to identify pre-malignant lesions (Photo courtesy of Bilreiro C, et al. Investigative Radiology, 2024)

Pancreatic cancer is the leading cause of cancer-related fatalities. When the disease is localized, the five-year survival rate is 44%, but once it has spread, the rate drops to around 3%. The symptoms of pancreatic cancer, including stomach pain, unexplained weight loss, new-onset diabetes, and jaundice, are non-specific and often resemble those of other conditions. By the time these symptoms appear, the cancer is typically already advanced and inoperable. Approximately 95% of pancreatic cancers are pancreatic ductal adenocarcinomas (PDAC), with many originating from a precursor lesion called pancreatic intraepithelial neoplasia (PanIN). Detecting pre-malignant lesions, particularly PanINs, is essential for diagnosing PDAC early and understanding PanIN biology. However, unlike colorectal cancer, where polyps can be easily seen and removed during a colonoscopy, pancreatic cancer lacks non-invasive diagnostic tools for the early detection of PanINs. This limitation also hinders research on PanIN biology and the development of pancreatic tumors in humans. Additionally, PanINs are not identifiable with current imaging techniques, as precursor lesions in the pancreas are difficult to detect using magnetic resonance imaging (MRI). Therefore, there is a pressing need for advanced imaging methods to detect and characterize PanINs, enabling early diagnosis before PDAC develops.

A new study by researchers at the Champalimaud Foundation (Lisboa, Portugal) has demonstrated, for the first time, that Diffusion Tensor Imaging (DTI), a particular form of MRI, can effectively detect pre-malignant lesions in the pancreas. Published in the journal Investigative Radiology, the study could pave the way for early clinical diagnosis and treatment assessment in individuals at risk for pancreatic cancer. DTI is based on the diffusion of water molecules in tissues, which interact with cell walls and other microscopic structures, making them useful as endogenous tracers of tissue microstructure. While DTI is commonly used for brain imaging, its application for detecting pancreatic cancer precursor lesions has never been explored.

The team of scientists and clinicians embarked on this collaborative study keeping translation to the clinics in mind, considering that the most efficient strategy would be to test a method that already exists, instead of developing something completely new – and unproven. They began by imaging transgenic mouse pancreatic tissue samples using one of the world’s most advanced MRI scanners, a 16.4 Tesla ultrahigh-field MRI machine, compared to the 1.5T or 3T scanners commonly used in clinical settings. They then compared the DTI images with histological analysis of the same tissue samples to confirm if the lesions detected by DTI corresponded with those seen in histology. Histology involves examining thin slices of prepared tissue under a microscope to study cell structures and tumor characteristics. The results were a perfect match.

By leveraging the capabilities of the high-field MRI equipment, the team developed a magnetic resonance microscopy technique that allowed for direct comparison between DTI images and histology slides. This technique demonstrated that advanced DTI sequences could successfully identify pre-malignant lesions of pancreatic cancer. The team further showed that these lesions could be detected in vivo in transgenic mice, specifically engineered to develop PanINs. Finally, human tissue samples were imaged, confirming that the method was also effective for detecting lesions in humans. Histology and pathology results from the human samples validated the efficacy of DTI in detecting pancreatic cancer precursor lesions.

“I believe this study represents a milestone in research into premalignant pancreatic cancer lesions,” said Carlos Bilreiro, a doctor at the Champalimaud Clinical Centre’s Radiology Department and first author of the study. “We are now able to detect these lesions in animals and better understand how pancreatic cancer develops. We also know that DTI is just as effective in the human pancreas. As for its clinical application, further studies will be needed to adapt the technique to the clinical context and to explore interventional or surveillance possibilities for pre-malignant lesions. This study thus represents a first step towards the early detection of pancreatic cancer with magnetic resonance imaging, even before the cancer develops.”

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75 (44.822692871094): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

76 (86.069107055664): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (130.17654418945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

91 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

92 (79.870223999023): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294803428 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

93 (103.95050048828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

94 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

95 (751.01852416992): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294803428 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

96 (829.93507385254): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

97 (702.1427154541): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

98 (130.89179992676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

99 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

100 (108.00361633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

101 (50.783157348633): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

102 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

103 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

104 (74.148178100586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

105 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

106 (452.04162597656): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

107 (!!!!! 27235.03112793): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

108 (751.97219848633): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294803428 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294803428 AND type='deeppockets_item' AND published='1' LIMIT 1

109 (!!!!! 12592.077255249): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

110 (124.93133544922): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

111 (383.85391235352): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

112 (71.048736572266): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

113 (334.02442932129): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

114 (99.897384643555): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

115 (49.114227294922): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

116 (46.014785766602): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

117 (263.92936706543): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

118 (58.174133300781): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

119 (403.16581726074): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

120 (226.02081298828): SELECT name FROM jos_deeppockets WHERE id=212

121 (75.101852416992): SELECT name FROM jos_deeppockets WHERE id=212

122 (779.86717224121): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

123 (805.85479736328): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

124 (131.13021850586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

125 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

126 (!!!!! 13160.943984985): TRUNCATE TABLE jos_trademed_module

127 (164.98565673828): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294803428 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

128 (977.99301147461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

129 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

130 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

131 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

132 (!!!!! 1381.1588287354): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

133 (106.0962677002): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

134 (75.817108154297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

135 (61.03515625): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294803428 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294803428 AND type='deeppockets_item' AND published='1' LIMIT 1

136 (44.822692871094): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

137 (41.961669921875): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

138 (54.121017456055): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

139 (283.00285339355): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

140 (135.89859008789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294803428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294803428 AND published='1' LIMIT 1

141 (108.95729064941): select jos_twitters.link from jos_twitters where cat=10

142 (35.04753112793): select jos_facebook.link from jos_facebook where cat=10

143 (34.093856811523): select jos_google_plus.link from jos_google_plus where cat=10

144 (34.093856811523): select jos_linkedin.link from jos_linkedin where cat=10

145 (323.05717468262): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

146 (!!!!! 1230.001449585): insert into jos_banners_delta values (14615,'2025-07-31 12:32:41','216.73.216.8','view'),(14202,'2025-07-31 12:32:41','216.73.216.8','view'),(14203,'2025-07-31 12:32:41','216.73.216.8','view')

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