News | PET-MRI | December 10, 2020

Post-neoadjuvant therapy changes in metabolic metrics from PET/MRI and morphologic metrics from CT were associated with pathologic response and overall survival in patients with pancreatic ductal adenocarcinoma

Post-neoadjuvant therapy changes in metabolic metrics from PET/MRI and morphologic metrics from CT were associated with pathologic response and overall survival in patients with pancreatic ductal adenocarcinoma

Pre-treatment (A-C) and post-treatment (D-F) images after eight cycles of systemic FOLFIRINOX and consolidative chemoradiation. Baseline CA 19-9 was 145 U/ml. Pre-treatment whole body axial fused PET/MRI showed FDG avid lesion in body of pancreas (arrow, A) with SUVmax 7.1 and SUVgluc 8.0. Lesion was hypo-enhancing on axial contrast-enhanced T1-weighted (T1W) MR image (arrow, B) from focused abdominal PET/MRI and on CT (arrow, C). Pre-treatment CT tumor volume was 10.3 cm3. Post-treatment whole body axial fused PET/MRI showed complete metabolic response (arrow D) with SUVmax 1.9 and SUVgluc 1.9. Lesion was indistinct on axial contrast-enhanced T1W MRI (arrow, E) and CT (arrow, F), and there was upstream pancreatic parenchymal atrophy. Post-treatment CT tumor volume was 0.46 cm3. There was normalization of CA 19-9. Relative change in SUVmax (ΔSUVgluc) was -73%, and relative change in SUVgluc (ΔSUVgluc) was -76%. Based on change in tumor size, response was categorized as partial response per RECIST. Relative change in tumor volume (ΔTvol) was -96%. Pathology showed major pathologic response (College of American Pathologists score 1.) Images courtesy of American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)


December 10, 2020 — According to an open-access Editor's Choice article in ARRS' American Journal of Roentgenology (AJR), post-neoadjuvant therapy (NAT) changes in metabolic metrics from PET/MRI and morphologic metrics from CT were associated with pathologic response and overall survival in patients with pancreatic ductal adenocarcinoma (PDA).

"Imaging metrics associated with pathologic response and overall survival in PDA could help guide clinical management and outcomes for patients with PDA receiving emergent therapeutic interventions," wrote first author Ananya Panda of the department of radiology at the Mayo Clinic in Rochester, Minnesota.

Panda and colleagues' retrospective study included 44 patients (22 men, 22 women; average age 62) with 18F-FDG avid borderline resectable or locally advanced PDA on pre-treatment PET/MRI, who also underwent post-NAT PET/MRI prior to surgery between August 2016 and September 2019. CA 19-9, metabolic metrics from PET/MRI, and morphologic metrics from CT (n = 34) were compared between pathologic responders (College of American Pathologists scores 0 and 1] and nonresponders (scores 2 and 3).

In borderline resectable or locally advanced pancreatic cancer undergoing neoadjuvant therapy, pre- vs. post-treatment changes in tumor metrics on PET/MRI (complete metabolic response, ΔSUVmax, ΔSUVgluc) and CT (RECIST, volume change) were associated with major pathologic response (AUC = 0.71-0.83; p < 0.05).

Reiterating that PET/MRI and CT metrics can help guide post-NAT pancreatic cancer treatment decisions, the authors of this AJR article concluded that by comparison, serum CA 19-9 was not associated with pathologic response or survival.

For more information: www.arrs.org


Related Content

News | Pediatric Imaging

December 1, 2023 — The Radiation Oncology Program at Children’s Hospital Los Angeles is one of only a few in the country ...

Time December 01, 2023
arrow
News | RSNA

December 1, 2023 — In today's healthcare environment, the industry faces various pressing challenges. The magnetic ...

Time December 01, 2023
arrow
News | Radiology Imaging

November 30, 2023 — Through its leading imaging solutions and commitment to innovation, GE HealthCare remains at the ...

Time November 30, 2023
arrow
News | Artificial Intelligence

November 28, 2023 — iCAD, Inc., a global medical technology leader in innovative cancer-detection solutions, and ...

Time November 28, 2023
arrow
News | Computed Tomography (CT)

November 28, 2023 — Smoking marijuana in combination with cigarettes may lead to increased damage of the lung’s air sacs ...

Time November 28, 2023
arrow
News | RSNA

November 27, 2023 — Black patients underwent medical imaging for cognitive impairment years later than white and ...

Time November 27, 2023
arrow
News | Treatment Planning

November 26, 2023 — TeleDaaS, PLLC, a leading dosimetry-as-a-service provider, made its official debut today at the ...

Time November 26, 2023
arrow
News | Quality Assurance (QA)

November 25, 2023 — Mirion announced that it will debut the new Instadose VUE personal dosimeter, from its Dosimetry ...

Time November 25, 2023
arrow
News | Radiology Imaging

November 23, 2023 — Fujifilm Healthcare Americas Corporation, a leading provider of diagnostic and enterprise imaging ...

Time November 23, 2023
arrow
News | Lung Imaging

November 22, 2023 — Using a routine chest X-ray image, an artificial intelligence (AI) tool can identify non-smokers who ...

Time November 22, 2023
arrow
Subscribe Now