• Cohort 1 - Feasibility of multiparametric endoscopic ultrasound (mpEUS) imaging of patients at high-risk for pancreatic cancer:

⁃ Patient Group: those having standard endoscopic ultrasounds because they are at high risk of pancreatic cancer Participants enrolled into the Memorial Sloan Kettering Cancer Center Pancreatic Registry protocol (IRB#: 02-102) will be eligible for this study. Specifically, related individuals without pancreatic cancer who are at-risk for developing pancreatic cancer and meet all of the following criteria (family health history will be self-reported):

• 10 years younger than the earliest pancreatic cancer diagnosis in the family

• Be at least 50 years old

• Be at least 40 years old if diagnosed with FAMMM syndrome (CDKN2A/p16) or Hereditary Pancreatitis (PRSS1, SPINK1/PST1, CTRC, CPA1 or other candidate hereditary pancreatitis genes)

• Be at least 35 years old if diagnosed with Peutz-Jeghers syndrome (STK11 aka LKB1)

• Not pregnant and not Nursing

• Relatives at least 21 years old with other high-risk clinical criteria that warrants pancreatic cancer surveillance or follow-up as determined by the project leader (Dr. Vineet Rolston)

• Must agree to be contacted for follow-up

• Must satisfy at least one of the following 4 criteria:

‣ Have at least two affected relatives who are a first-degree relative to each other, of whom at least one is a first degree relative to the individual OR have at least two affected first-degree relatives on the same side of the family.

⁃ Have at least one first- or second-degree affected relative and have germline genetic test results that confirm a likely pathogenic or pathogenic variant in at least one of the following genes:

• APC (Familial Adenomatous Polyposis (FAP) and Attenuated FAP syndrome

∙ BRCA1(Hereditary Breast and Ovarian Cancer Symptoms)

∙ MLH1, MSH2, MSH6, PMS2, or EPCAM (Lynch Syndrome)

∙ PALB2

∙ TP53 (Li-Fraumeni Syndrome)

∙ Other established pancreatic cancer predisposition gene per project leader's discretion

⁃ Have germline genetic test results that confirm a likely pathogenic or pathogenic variant in one or more of the following genes:

• CDKN2A/p16 (Familial Atypical Multiple Mole Melanoma Syndrome (FAMMM))

∙ STK11 aka LKB1 (Peutz-Jeghers Syndrome)

∙ PRSS1, SPINK1/PST1, CTRC, CPA1 or other candidate hereditary pancreatitis genes per project leader's discretion

∙ ATM (ataxia telangiectasia mutated)

∙ BRCA 2(Hereditary Breast and Ovarian Cancer Symptoms)

⁃ Relatives at least 21 years old with other high-risk clinical criteria that warrants pancreatic cancer surveillance or follow-up as determined the project leader (Dr. Vineet Rolston)

⁃ Cohort 2 - Multiparametric endoscopic ultrasound imaging (mpEUS) of patients with pancreatic ductal adenocarcinoma:

⁃ Patient Group: those with pancreatic cancer having endoscopic ultrasound-guided biopsies

⁃ Patients will be entered into the study if they meet the following criteria:

• Patients with pancreatic ductal adenocarcinoma

• Are undergoing endoscopic ultrasound-guided tissue core biopsy as part of their standard of care

• Not pregnant and not nursing

⁃ Cohort 3 - Thyroid nodule assessment with multiparametric ultrasound (mpUS) imaging:

⁃ Patient Group: those with a thyroid nodule that will be biopsied whether they have known cancer or not

• Are undergoing ultrasound-guided thyroid biopsy as part of their standard of care

• Not pregnant and not nursing

⁃ Healthy Volunteers will be entered into the study if they meet the following criteria:

• No known cancer diagnosis or thyroid nodules

• Age ≥ 18

• Able to understand and give informed consent

• Not pregnant and not nursing