Inclusion criteria  Both males and females will be enrolled and must be at least 18 years of age and under age of 90 Patients at high risk of developing a pancreatic malignancy. Patients undergoing EUS or receiving an MRI scan as part of their screening. Institutional Review Board (IRB)-approved consent must be signed by patients to participate in this study.  Exclusion criteria  Patient under the age of 18 and over the age 90 Patients undergoing FNA  Contraindications to EUS as determined by study investigators.  Patient with uncorrectable coagulopathy Patient that cannot undergo anesthesia due to cardio- pulmonary contraindication as deemed by the anesthesiologist Patients undergoing EUS or ERCP for a suspected bile duct cancer arising from the intrahepatic or extrahepatic biliary epithelium Pregnant females will be excluded. Patient that is unable to provide informed consent Patient with known allergy to Lumason or Secretin Patients with an elevated baseline lipase level