BACKGROUND & AIMS The risk of pancreatic cancer is increased in patients with a strong family history of pancreatic cancer or a predisposing germline mutation. Screening can detect curable, non-invasive pancreatic neoplasms, but the optimal imaging approach is not known. We determined the baseline prevalence and characteristics of pancreatic abnormalities using 3 imaging tests to screen asymptomatic, high-risk individuals (HRI). METHODS We screened 225 asymptomatic adult HRI at 5 academic US medical centers once, using computed tomography (CT), magnetic resonance imaging (MRI), and endoscopic ultrasonography (EUS). We compared results in a blinded, independent fashion. RESULTS Ninety-two of 216 HRI (42%) were found to have at least 1 pancreatic mass (84 cystic, 3 solid) or a dilated pancreatic duct (n=5) by any of the imaging modalities. Fifty-one of the 84 HRI with a cyst (60.7%) had multiple lesions, typically small (mean 0.55 cm, range 2–39 mm), in multiple locations. The prevalence of pancreatic lesions increased with age; they were detected in 14% of subjects <50 years old, 34% of subjects 50–59 years old, and 53% of subjects 60–69 years old (P<.0001). CT, MRI, and EUS detected a pancreatic abnormality in 11%, 33.3%, and 42.6% of the HRI, respectively. Among these abnormalities, proven or suspected neoplasms were identified in 85 HRI (82 intraductal papillary mucinous neoplasms [IPMN] and 3 pancreatic endocrine tumors). Three of 5 HRI who underwent pancreatic resection had high-grade dysplasia in <3 cm IPMNs and in multiple intraepithelial neoplasias. CONCLUSIONS Screening of asymptomatic HRI frequently detects small pancreatic cysts, including curable, non-invasive high-grade neoplasms. EUS and MRI detect pancreatic lesions better than CT.

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Field, structural, and metamorphic petrology investigations of Mabja gneiss dome, southern Tibet, suggest that contractional, extensional, and diapiric processes contributed to the structural evolution and formation of the domal geometry. The dome is cored by migmatites overlain by sillimanite-zone metasedimentary rocks and orthogneiss; metamorphic grade diminishes upsection and is defined by a series of concentric isograds. Evidence for three major deformational events, two older penetrative contractional and extensional events and a younger doming event, is preserved. Metamorphism, migmitization, and emplacement of a leucocratic dike swarm were syntectonic with the extensional event at mid-crustal levels. Metamorphic temperatures and pressures range from , 500 8C and , 150-450 MPa in chloritoid-zone rocks to 705^65 8C and 820^100 MPa in sillimanite-zone rocks. We suggest that adiabatic decompression during extensional collapse contributed to development of migmatites. Diapiric rise of low density migmatites was the driving force, at least in part, for the development of the domal geometry. The structural and metamorphic histories documented in Mabja Dome are similar to Kangmar Dome, suggesting widespread occurrence of these events throughout southern Tibet. q

New geologic mapping, tectonic geomorphologic, 10Be terrestrial cosmogenic nuclide, and (U‐Th)/He zircon and apatite thermochronometric data provide the first numerical constraints on late Cretaceous to late Quaternary exhumation of the Inyo Mountains and vertical slip and horizontal extension rates across the eastern Inyo fault zone, California. The east‐dipping eastern Inyo fault zone bounds the eastern flank of the Inyo Mountains, a prominent geomorphic feature within the western Basin and Range Province and eastern California shear zone. (U‐Th)/He zircon and apatite thermochronometry yield age patterns across the range that are interpreted as indicating: (1) two episodes of moderate to rapid exhumation associated with Laramide deformation during the late Cretaceous/early Tertiary; (2) development of a slowly eroding surface during a prolonged period from early Eocene to middle Miocene; (3) rapid cooling, exhumation, and initiation of normal slip along the eastern Inyo fault zone, accommodated by westward tilting of the Inyo Mountains block, at 15.6 Ma; and (4) rapid cooling, exhumation, and renewed normal slip along the eastern Inyo fault zone at 2.8 Ma. Fault slip continues today as indicated by fault scarps that cut late Pleistocene alluvial fan surfaces. The second episode of normal slip at 2.8 Ma also signals onset of dextral slip along the Hunter Mountain fault, yielding a Pliocene dextral slip rate of 3.3 ± 1.0 mm/a, where a is years. Summing this dextral slip rate with estimated dextral slip rates along the Owens Valley, Death Valley, and Stateline faults yields a net geologic dextral slip rate across the eastern California shear zone of 9.3 + 2.2/–1.4 to 9.8 + 1.4/–1.0 mm/a.