| 1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin 2023;73:17-48. |
Review/Other-Dx |
N/A |
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence and outcomes using incidence data collected by central cancer registries and mortality data collected by the National Center for Health Statistics. |
In 2023, 1,958,310 new cancer cases and 609,820 cancer deaths are projected to occur in the United States. Cancer incidence increased for prostate cancer by 3% annually from 2014 through 2019 after two decades of decline, translating to an additional 99,000 new cases; otherwise, however, incidence trends were more favorable in men compared to women. For example, lung cancer in women decreased at one half the pace of men (1.1% vs. 2.6% annually) from 2015 through 2019, and breast and uterine corpus cancers continued to increase, as did liver cancer and melanoma, both of which stabilized in men aged 50 years and older and declined in younger men. However, a 65% drop in cervical cancer incidence during 2012 through 2019 among women in their early 20s, the first cohort to receive the human papillomavirus vaccine, foreshadows steep reductions in the burden of human papillomavirus-associated cancers, the majority of which occur in women. Despite the pandemic, and in contrast with other leading causes of death, the cancer death rate continued to decline from 2019 to 2020 (by 1.5%), contributing to a 33% overall reduction since 1991 and an estimated 3.8 million deaths averted. This progress increasingly reflects advances in treatment, which are particularly evident in the rapid declines in mortality (approximately 2% annually during 2016 through 2020) for leukemia, melanoma, and kidney cancer, despite stable/increasing incidence, and accelerated declines for lung cancer. In summary, although cancer mortality rates continue to decline, future progress may be attenuated by rising incidence for breast, prostate, and uterine corpus cancers, which also happen to have the largest racial disparities in mortality. |
4 |
| 2. Garces-Descovich A, Beker K, Jaramillo-Cardoso A, James Moser A, Mortele KJ. Applicability of current NCCN Guidelines for pancreatic adenocarcinoma resectability: analysis and pitfalls. Abdom Radiol. 43(2):314-322, 2018 02. |
Observational-Dx |
102 patients |
To test the applicability of National Comprehensive Cancer Network (NCCN v 3.2017) resectability criteria for pancreatic ductal adenocarcinoma (PDAC) in clinical practice, at a high-volume tertiary referral center. |
Among 102 patients, 10 (10%) had CTA evidence of vascular involvement that did not conform to existing NCCN Guidelines. Six new scenarios of vascular involvement were identified. The remaining 92 patients presented with resectable (n = 20 [22%]), borderline resectable (n = 42 [45.6%]), or unresectable (n = 30 [33%]) PDAC. Approximately half (n = 21 [51%]) of borderline resectable patients' tumors demonstrated isolated venous involvement, whereas 39% had both arterial and venous involvement. A minority (11%) demonstrated only major arterial involvement. Assignment to unresectable status reflected both arterial and venous involvement (11, 37%), arterial involvement only (10, 33%) patients, and unreconstructible venous involvement in 9 (30%). |
3 |
| 3. Akita H, Takahashi H, Ohigashi H, et al. FDG-PET predicts treatment efficacy and surgical outcome of pre-operative chemoradiation therapy for resectable and borderline resectable pancreatic cancer. Eur J Surg Oncol. 43(6):1061-1067, 2017 Jun. |
Observational-Dx |
83 pancreatic cancer patients who underwent FDG-PET before and after neoadjuvant chemoradiotherapy (NACRT) |
To examine the utility of FDG-PET in predicting the efficacy of neoadjuvant chemoradiotherapy (NACRT) and outcome after radical surgery. |
Evans grade I, IIA, IIB, III, and IV was determined in 11, 31, 27, 11, and 3 patients, respectively. The maximum SUVs after NACRT (post SUV-max) and tumor size were significantly decreased compared to pretreatment values (p < 0.001 and p = 0.007, respectively). The post SUV-max and regression index were significantly related to grade III/IV (p = 0.04 and p < 0.001, respectively), but only the regression index predicted NACRT efficacy (p = 0.002). The AUC of the regression index for the detection of grade III/IV was 0.822, and 13 of 14 grade III/IV patients were picked up using 50% as the threshold (p < 0.001). Patients with a regression index >50% had a significantly better prognosis after radical resection than patients with <50% (p = 0.032). Regression index as well as pathological lymph node status and resectability status were independent prognostic factors in multivariate analysis (exp 2.086, p = 0.043). |
4 |
| 4. Fogelman DR, Varadhachary G. Medical oncology and pancreatic cancer: what the radiologist needs to know. [Review]. Abdom Radiol. 43(2):383-392, 2018 02. |
Review/Other-Dx |
N/A |
To review the fine points of imaging that distinguish resectable from borderline or unresectable patients, explain the principles of neoadjuvant and adjuvant therapy for pancreatic cancer, highlight some of the novel therapies now being pioneered in pancreatic cancer, and review radiologic features important for palliative care in patients with these tumors. |
No results stated in abstract. |
4 |
| 5. Barreto SG, Loveday B, Windsor JA, Pandanaboyana S. Detecting tumour response and predicting resectability after neoadjuvant therapy for borderline resectable and locally advanced pancreatic cancer. [Review]. ANZ J Surg. 89(5):481-487, 2019 05. |
Meta-analysis |
995 patients; 15 studies |
To determine the accuracy of imaging modalities to predict resectability and R0 resection for borderline resectable (BRPC) or locally advanced pancreatic cancer (LAPC) after neoadjuvant therapy (NAT). |
Fifteen studies identified 995 patients of which 683 had BRPC and 312 LAPC. Computed tomography (CT) scan was the most common modality for re-staging (n = 14), followed by positron emission tomography (PET)-CT (n = 3) and endosonography (EUS) (n = 2). Stable disease on RECIST criteria was found in 67% of patients (range 53-80%) with 20% demonstrating reduction in tumour size. A total of 60% of patients underwent surgery post-NAT (range 31-85%) with a R0 rate of 88% (range 57-100%). Accuracy for predicting R0 resectability and T-stage on CT scan was 71 and 49%. A reduction in SUV(max) on PET-CT and reduction of tumour stiffness on EUS elastography positively correlated with resectability. |
Good |
| 6. Jang JK, Byun JH, Kang JH, et al. CT-determined resectability of borderline resectable and unresectable pancreatic adenocarcinoma following FOLFIRINOX therapy. Eur Radiol. 31(2):813-823, 2021 Feb. |
Observational-Dx |
64 patients |
To assess the ability of CT-determined resectability, as defined by a recent version of NCCN criteria, and associated CT findings to predict margin-negative (R0) resection in patients with PDAC after neoadjuvant FOLFIRINOX chemotherapy. |
R0 resection rate did not differ significantly among the resectable, borderline resectable, or unresectable PDAC (67-73%, p = 0.95) or among PDAC with regression, stability, or progression (56-77%, p = 0.39). The sensitivity and specificity for R0 resection were 67% and 37%, respectively, for resectability (resectable/borderline vs. unresectable) and 80% and 21%, respectively, for changes in resectability (regression/stable vs. progression). Low-contrast enhancement of soft tissue contacting artery (</= 46.4 HU) was independently associated with R0 resection (p = 0.01). |
3 |
| 7. Wagner M, Antunes C, Pietrasz D, et al. CT evaluation after neoadjuvant FOLFIRINOX chemotherapy for borderline and locally advanced pancreatic adenocarcinoma. Eur Radiol. 27(7):3104-3116, 2017 Jul. |
Observational-Dx |
36 patients |
To assess anatomic changes on computed tomography (CT) after neoadjuvant FOLFIRINOX (5-fluorouracil/leucovorin/irinotecan/oxaliplatin) chemotherapy for secondary resected borderline resectable (BR) and locally advanced (LA) pancreatic adenocarcinoma and their accuracy to predict resectability and pathological response. |
Thirty-one patients had R0 resection, including only six exhibiting a downstaging according to the NCCN classification. After treatment, the largest axis and P3A decreased (P < 0.0001). The pre-surgical largest axis and P3A were smaller in case of R0 resection (P = 0.019/P = 0.021). The largest axis/P3A variations were higher in case of complete pathological response (P = 0.011/P = 0.016). A decrease of the arterial/venous involvement was not able to predict R0 or ypT0N0 (P > 0.05). Progression of the vascular involvement was seen in two (5 %) patients and led to a shorter DFS. |
3 |
| 8. Hafezi-Nejad N, Fishman EK, Zaheer A. Imaging of post-operative pancreas and complications after pancreatic adenocarcinoma resection. [Review]. Abdom Radiol. 43(2):476-488, 2018 02. |
Review/Other-Dx |
N/A |
To discuss, with case examples, some of such common and uncommon findings on imaging to familiarize the abdominal radiologists evaluating post-operative imaging in both acute and chronic post-operative settings. |
No results stated in abstract. |
4 |
| 9. Kambadakone AR, Zaheer A, Le O, et al. Multi-institutional survey on imaging practice patterns in pancreatic ductal adenocarcinoma. Abdom Radiol. 43(2):245-252, 2018 02. |
Observational-Dx |
N/A |
To study the practice patterns for performance and interpretation of CT/MRI imaging studies in patients with pancreatic ductal adenocarcinoma (PDAC) at multiple institutions using a survey-based assessment. |
The response rate was 89.6% (43/48), with majority of the respondents working in a teaching hospital or academic research center (95.4%). While 86% of radiologists reported use of structured reporting templates in their practice, only 60.5% used standardized templates specific to PDAC. This lower percentage was despite most of them (77%) being aware of existence of PDAC-specific templates and recognizing their benefits, such as preference by referring providers (83%), improved uniformity (100%), and higher accuracy of reports (76.2%). The common impediments to the use of PDAC-specific templates were interference with efficient workflow (67.5%), lack of interest (52.5%), and complexity of existing templates (47.5%). With regards to imaging practice, 92.7% (n = 40/43) of respondents reported performing dynamic multiphasic pancreatic protocol CT for evaluation of patients with initial suspicion or staging of PDAC. |
4 |
| 10. Kulkarni NM, Mannelli L, Zins M, et al. White paper on pancreatic ductal adenocarcinoma from society of abdominal radiology's disease-focused panel for pancreatic ductal adenocarcinoma: Part II, update on imaging techniques and screening of pancreatic cancer in high-risk individuals. [Review]. Abdom Radiol. 45(3):729-742, 2020 03. |
Review/Other-Dx |
N/A |
To review recent updates in imaging techniques and the current status of screening and surveillance of individuals at a high risk of developing PDAC. |
No results stated in abstract. |
4 |
| 11. Canto MI, Almario JA, Schulick RD, et al. Risk of Neoplastic Progression in Individuals at High Risk for Pancreatic Cancer Undergoing Long-term Surveillance. Gastroenterology. 155(3):740-751.e2, 2018 09. |
Observational-Dx |
354 patients |
To investigate the incidence of PDAC and risk factors for neoplastic progression in individuals at high risk for PDAC enrolled in a long-term screening study. |
During the follow-up period, pancreatic lesions with worrisome features (solid mass, multiple cysts, cyst size > 3 cm, thickened/enhancing walls, mural nodule, dilated main pancreatic duct > 5 mm, or abrupt change in duct caliber) or rapid cyst growth (>4 mm/year) were detected in 68 patients (19%). Overall, 24 of 354 patients (7%) had neoplastic progression (14 PDACs and 10 HGDs) over a 16-year period; the rate of progression was 1.6%/year, and 93% had detectable lesions with worrisome features before diagnosis of the PDAC or HGD. Nine of the 10 PDACs detected during routine surveillance were resectable; a significantly higher proportion of patients with resectable PDACs survived 3 years (85%) compared with the 4 subjects with symptomatic, unresectable PDACs (25%), which developed outside surveillance (log rank P < .0001). Neoplastic progression occurred at a median age of 67 years; the median time from baseline screening until PDAC diagnosis was 4.8 years (interquartile range, 1.6-6.9 years). |
3 |
| 12. Lorenzo D, Rebours V, Maire F, et al. Role of endoscopic ultrasound in the screening and follow-up of high-risk individuals for familial pancreatic cancer. [Review]. World J Gastroenterol. 25(34):5082-5096, 2019 Sep 14. |
Review/Other-Dx |
N/A |
To review the role of endoscopic ultrasound in the screening and follow-up of high-risk individuals for familial pancreatic cancer. |
No results stated in abstract. |
4 |
| 13. Dudley B, Brand RE. Pancreatic Cancer Surveillance and Novel Strategies for Screening. [Review]. Gastrointest Endosc Clin N Am. 32(1):13-25, 2022 Jan. |
Review/Other-Dx |
N/A |
To discuss pancreatic cancer surveillance and novel strategies for screening. |
No results stated in abstract. |
4 |
| 14. Huang C, Simeone DM, Luk L, et al. Standardization of MRI Screening and Reporting in Individuals With Elevated Risk of Pancreatic Ductal Adenocarcinoma: Consensus Statement of the PRECEDE Consortium. AJR Am J Roentgenol. 219(6):903-914, 2022 12. |
Review/Other-Dx |
N/A |
To present a consensus statement to standardize MRI screening and reporting for individuals with elevated risk of pancreatic cance |
No results stated in abstract. |
4 |
| 15. Klatte DCF, Boekestijn B, Wasser MNJM, et al. Pancreatic Cancer Surveillance in Carriers of a Germline CDKN2A Pathogenic Variant: Yield and Outcomes of a 20-Year Prospective Follow-Up. J Clin Oncol. 40(28):3267-3277, 2022 10 01. |
Observational-Dx |
347 patients |
To evaluate the yield and outcomes of 20 years of prospective surveillance in a large cohort of individuals with germline pathogenic variants (PVs) in CDKN2A. |
Three hundred forty-seven germline PV carriers participated in surveillance and were followed for a median of 5.6 (interquartile range 2.3-9.9) years. A total of 36 cases of PDAC were diagnosed in 31 (8.9%) patients at a median age of 60.4 (interquartile range 51.3-64.1) years. The cumulative incidence of primary PDAC was 20.7% by age 70 years. Five carriers (5 of 31; 16.1%) were diagnosed with a second primary PDAC. Thirty (83.3%) of 36 PDACs were considered resectable at the time of imaging. Twelve cases (12 of 36; 33.3%) presented with stage I disease. The median survival after diagnosis of primary PDAC was 26.8 months, and the 5-year survival rate was 32.4% (95% CI, 19.1 to 54.8). Individuals with primary PDAC who underwent resection (22 of 31; 71.0%) had an overall 5-year survival rate of 44.1% (95% CI, 27.2 to 71.3). Nine (2.6%; 9 of 347) individuals underwent surgery for a suspected malignant lesion, which proved to not be PDAC, and this included five lesions with low-grade dysplasia. |
4 |
| 16. Overbeek KA, Cahen DL, Canto MI, Bruno MJ. Surveillance for neoplasia in the pancreas. Best Pract Res Clin Gastroenterol. 2016;30(6):971-986. |
Review/Other-Dx |
N/A |
To discuss which individuals are eligible for surveillance, which lesions are aimed to be detected, and which surveillance modalities are being used in current clinical practice. |
No results stated in abstract. |
4 |
| 17. Ohno E, Hirooka Y, Kawashima H, et al. Natural history of pancreatic cystic lesions: A multicenter prospective observational study for evaluating the risk of pancreatic cancer. J Gastroenterol Hepatol. 33(1):320-328, 2018 Jan. |
Review/Other-Dx |
881 patients |
To elucidate the natural history of pancreatic cystic lesions (PCLs), including branch duct-type intraductal papillary mucinous neoplasm (BD-IPMN), via midterm follow-up analysis of a multicenter prospective observational study (NSPINAL study). |
The 664 patients (358 men) were followed for a median of 33.5 months (interquartile range 29). The cyst and main pancreatic duct sizes were 16.6 +/- 9.3 and 2.3 +/- 1.0 mm, respectively. Morphologically, 518 cases were multilocular, 137 were unilocular, and 9 had a honeycomb pattern; 269 cases involved multifocal lesions. Ninety-six patients (14.5%) showed worsening progression on imaging. There were two resectable and four unresectable cases of pancreatic ductal adenocarcinoma and three cases of malignant BD-IPMN. The 3-year risk of developing PC was 1.2%. The standardized incidence ratio for PC among PCLs was 10.0 (95% confidence interval 3.5-16.5), and the standardized incidence ratio among BD-IPMN was 16.6 (95% confidence interval 5.1-28.1). Multivariate analysis showed that development of symptoms and worsening progression were significant predictors of PC. |
4 |
| 18. Hirono S, Kawai M, Okada KI, et al. Factors Associated With Invasive Intraductal Papillary Mucinous Carcinoma of the Pancreas. JAMA Surg. 152(3):e165054, 2017 03 15. |
Observational-Dx |
286 patients |
To identify the specific factors associated with invasive intraductal papillary mucinous neoplasms for branch duct, main duct, and mixed type carcinomas. |
Of the 286 patients included in the cohort, the median (range) age was 71 (28-86) years, and 162 (56.6%) were male. High mural nodule size was independently associated with invasive intraductal papillary mucinous carcinoma in all types (branch duct: odds ratio [OR], 1.992; 95% CI, 1.177-3.367; P = .01; main duct: OR, 1.443; 95% CI, 1.094-1.905; P = .01; and mixed: OR, 1.178; 95% CI, 1.057-1.312; P = .04). The cutoff values for intraductal papillary mucinous neoplasms, determined by a receiver operating characteristic, were 9 mm for branch duct and 6 mm for mixed and main duct carcinoma. A high carcinoembryonic antigen level in the pancreatic juice was independently associated with mixed (OR, 1.002; 95% CI, 1.000-1.003; P = .01) and main duct (OR, 1.002; 95% CI, 1.000-1.003; P = .048) carcinomas, and the cutoff values were determined to be 150 and 300 ng/mL, respectively (to convert to micrograms per liter, multiply by 1). In addition, both being female and having an elevated serum carbohydrate antigen 19-9 level were also found to be independently associated with mixed type invasive intraductal papillary mucinous carcinoma, and using any 2 among 4 identified factors yielded the highest accuracy (79.0%) for mixed type carcinomas. For all types, the accuracy for these factors was 86.0% for differentiating between invasive and noninvasive intraductal papillary mucinous neoplasms, which was superior to the accuracies using the "high-risk stigmata" factors or "worrisome features" suggested by the international consensus guideline in 2012 (66.1% and 39.9%, respectively). |
4 |
| 19. Lee T, Kim HJ, Park SK, et al. Natural courses of branch duct intraductal papillary mucinous neoplasm. Langenbecks Arch Surg. 402(3):429-437, 2017 May. |
Observational-Dx |
107 patients |
To elucidate the clinico-radiologic predictive factors for cancerous change detected by disease progression (PD) mainly defined by interval increase in cyst size and change of cyst morphology, for branch duct intraductal papillary mucinous neoplasm (BD-IPMN) patients with relatively long-term follow-up. |
During the mean +/- SD follow-up period of 51.5 +/- 24.5 months, PD was noticed in 43 (40.2%) of 107 BD-IPMN patients. Among these 107 patients, 21 (19.6%) displayed cancerous change. By univariate analyses, septated/multilocular cyst morphology, cyst size larger than 30 mm, cyst wall thickening, mural nodules, and the presence of symptoms were significant predictive factors for cancerous changes in BD-IPMN patients. A Cox forward stepwise linear regression model revealed that cyst wall thickening (OR 9.187, 95% CI 1.883~44.820, P < 0.01) and mural nodules (OR 6.224, 95% CI 1.311~29.549, P = 0.021) were significant and independent predictive factors for cancerous change in BD-IPMN patients. |
4 |
| 20. Hisada Y, Nagata N, Imbe K, et al. Natural history of intraductal papillary mucinous neoplasm and non-neoplastic cyst: long-term imaging follow-up study. J Hepatobiliary Pancreat Sci. 24(7):401-408, 2017 Jul. |
Observational-Dx |
526 patients |
To identify differences in incidence and mortality of pancreatic cancer (PC) between intraductal papillary mucinous neoplasm (IPMN) and non-neoplastic cyst. |
During a mean follow-up of 57.5 months with 3,376 computed tomography scans and 1,079 magnetic resonance imaging scans, 5-year cumulative PC incidence was 4.0% for IPMN and 0% for non-neoplastic cyst, respectively (HR 5.2; P = 0.031). During a mean follow-up of 73.1 months, 5-year cumulative PC-related mortality was 2.6% for IPMN and 0% for non-neoplastic cyst, respectively (HR 4.5; P = 0.05). Compared with the general population in Japan, patients with IPMN, but not those with non-neoplastic cyst, had significantly increased risks of PC incidence (SIR 22.03) and related mortality (SMR 15.9). |
3 |
| 21. Higashi M, Tanabe M, Onoda H, et al. Incidentally detected pancreatic adenocarcinomas on computed tomography obtained during the follow-up for other diseases. Abdom Radiol. 45(3):774-781, 2020 03. |
Observational-Dx |
119 patients |
To determine imaging findings of pancreatic adenocarcinomas incidentally detected on contrast-enhanced multiphasic dynamic computed tomography (CT) obtained during the follow-up for other diseases. |
In cancers of the pancreas body/tail, there was a significantly smaller tumor size (median, 17 mm vs. 42 mm, p < 0.001), a significantly lower incidence of loss of fatty marbling (p = 0.025), vascular involvement (p < 0.001), lymph node metastasis (p = 0.046) and distant metastasis (p = 0.017), and a significantly higher incidence of preserved lobulation (p < 0.001) in the incidental group than in the non-incidental group. Regarding the cancers of the pancreas head, there were no significant differences in the radiological findings between the two groups. On previous CT images, small pancreatic nodules, secondary signs, and loss of fatty marbling tended to be the preceding findings of incidental pancreatic adenocarcinomas. |
3 |
| 22. Singh DP, Sheedy S, Goenka AH, et al. Computerized tomography scan in pre-diagnostic pancreatic ductal adenocarcinoma: Stages of progression and potential benefits of early intervention: A retrospective study. Pancreatology. 20(7):1495-1501, 2020 Oct. |
Observational-Dx |
128 patients |
To study the stages of progression and potential benefits of CT scan in pre-diagnostic pancreatic ductal adenocarcinoma. |
CTs were abnormal in 16% and 85% at 24-36 and 3-6 months respectively, before PDAC diagnosis. The PDAC CTgram stages, findings and median lead times (months) to clinical diagnosis were: CTS I: Abrupt duct cut-off/duct dilatation (-12.8); CTS II: Low density mass confined to pancreas (-9.5), CTS III: Peri-pancreatic infiltration (-5.8), CTS IV: Distant metastases (only at diagnosis). PDAC survival was better in cohort B than in cohort A despite inclusion of lead time in Cohort A: CTS I (36 vs 17.2 months, p = 0.03), CTS II (35.2 vs 15.3 months, p = 0.04). |
4 |
| 23. Toshima F, Watanabe R, Inoue D, et al. CT Abnormalities of the Pancreas Associated With the Subsequent Diagnosis of Clinical Stage I Pancreatic Ductal Adenocarcinoma More Than 1 Year Later: A Case-Control Study. AJR Am J Roentgenol. 217(6):1353-1364, 2021 12. |
Observational-Dx |
103 patients |
To investigate findings of an earlier diagnosis of PDAC on CT examinations performed at least 1 year before the diagnosis of clinical stage I PDAC. |
A focal pancreatic abnormality was present on the most recent prediagnostic CT examination in 55/103 (53.4%) patients with PDAC versus 21/103 (20.4%) control patients (p < .001). In patients with PDAC, the most common focal abnormalities on prediagnostic CT were atrophy (39/103, 37.9%), faint enhancement (17/65, 26.2%), and MPD change (14/103, 13.6%), which were all more frequent in patients with PDAC than in control patients (p < .05). In 54/55 (98.2%) patients with PDAC, the PDAC corresponded to the site of a focal abnormality (exact location or the abnormality's upstream or downstream edge) on prediagnostic CT. Frequency of focal abnormalities decreased with increasing time before CT that detected PDAC (> 1 to </= 2 years before diagnosis, 64.9%; > 2 to </= 3 years, 49.2%; > 3 to </= 5 years, 41.8%; > 5 to </= 7 years, 29.7%; > 7 to </= 10 years, 18.5%; more than 10 years, 0%). Mean duration from the finding's initial appearance to diagnosis of PDAC was 4.6 years for atrophy, 3.3 years for faint enhancement, and 1.1 years for MPD change. |
3 |
| 24. Schima W, Bohm G, Rosch CS, Klaus A, Fugger R, Kopf H. Mass-forming pancreatitis versus pancreatic ductal adenocarcinoma: CT and MR imaging for differentiation. [Review]. Cancer Imaging. 20(1):52, 2020 Jul 23. |
Review/Other-Dx |
N/A |
To summarize the relevant computed tomography (CT) and magnetic resonance imaging (MRI) features that can help the radiologist to come to a confident diagnosis and to guide further management in equivocal cases. |
No results stated in abstract. |
4 |
| 25. Kulkarni NM, Hough DM, Tolat PP, Soloff EV, Kambadakone AR. Pancreatic adenocarcinoma: cross-sectional imaging techniques. [Review]. Abdom Radiol. 43(2):253-263, 2018 02. |
Review/Other-Dx |
N/A |
To describe cross-sectional imaging techniques for pancreatic adenocarcinoma. |
No results stated in abstract. |
4 |
| 26. Fukukura Y, Kumagae Y, Fujisaki Y, et al. Adding Delayed Phase Images to Dual-Phase Contrast-Enhanced CT Increases Sensitivity for Small Pancreatic Ductal Adenocarcinoma. AJR Am J Roentgenol. 217(4):888-897, 2021 10. |
Observational-Dx |
571 patients |
To assess the impact on diagnostic performance in detection of small PDAC when a delayed phase is added to dual-phase contrast-enhanced CT. |
AUC was higher (p < .05) for triple-phase than dual-phase images for all observers (observer 1, 0.97 vs 0.94; observer 2, 0.97 vs 0.94; observer 3, 0.97 vs 0.95). Sensitivity was higher (p < .001) for triple-phase than dual-phase images for all observers (observer 1, 74.2% [72/97] vs 59.8% [58/97]; observer 2, 88.7% [86/97] vs 71.1% [69/97]; observer 3, 86.6% [84/97] vs 72.2% [70/97]). Specificity, PPV, and NPV did not differ between image sets for any reader (p >/= .05). Seventeen tumors showed pancreatic phase visual isoattenuation, of which nine showed isoattenuation and eight hyperattenuation in the delayed phase. Of these 17 tumors, 16 were not detected by any observer on dual-phase images; of these 16, six were detected by at least two observers and five by at least one observer on triple-phase images. Visual attenuation showed excellent interob-server agreement (kappa = 0.89-0.96). |
2 |
| 27. Takaji R, Yamada Y, Matsumoto S, et al. Small pancreatic ductal carcinomas on triple-phase contrast-enhanced computed tomography: enhanced rims and the pathologic correlation. Abdom Radiol. 43(12):3374-3380, 2018 12. |
Observational-Dx |
45 patients |
To reveal the prevalence of small (</= 20 mm) pancreatic ductal carcinomas with enhanced rims on triple-phase contrast-enhanced CT and correlate the CT images with the pathologic findings. |
Enhanced rims were identified in 18 tumors (40%) by consensus between the two reviewers. The enhanced rims showed significantly higher mean attenuation values compared with the internal areas of the tumors (p < 0.001) and surrounding pancreatic parenchyma (p < 0.0086), and were most clearly visualized on equilibrium phase. The enhanced rims pathologically reflected the abundant fibrotic stroma with cancer cells in all tumors. There was no statistically significant difference in tumor invasiveness between the tumors with and without enhanced rims (anterior peripancreatic invasion, p = 0.137; posterior peripancreatic invasion, p = 0.758; portal vein invasion, p = 0.639; and lymph node metastases, p = 0.359). |
2 |
| 28. Fukukura Y, Kumagae Y, Higashi R, et al. Visual enhancement pattern during the delayed phase of enhanced CT as an independent prognostic factor in stage IV pancreatic ductal adenocarcinoma. Pancreatology. 20(6):1155-1163, 2020 Sep. |
Observational-Dx |
133 patients |
To determine whether visual tumor enhancement pattern on enhanced computed tomography (CT) can be used as a prognostic factor in stage IV PDAC treated with chemotherapy. |
On univariate analysis, the number of metastatic organs and the visual tumor enhancement pattern during the delayed phase were significantly associated with PFS (p = 0.003 and < 0.001, respectively) and OS (p = 0.005 and < 0.001, respectively). Multivariate analysis identified the number of metastatic organs (PFS, p = 0.021; OS, p = 0.041) and visual tumor enhancement pattern during the delayed phase (PFS, p < 0.001; OS, p < 0.001) as independent predictors of PFS and OS. |
3 |
| 29. Jhaveri KS, Babaei Jandaghi A, Thipphavong S, et al. Can preoperative liver MRI with gadoxetic acid help reduce open-close laparotomies for curative intent pancreatic cancer surgery? Cancer Imaging 2021;21:45. |
Review/Other-Dx |
N/A |
To study whether preoperative liver MRI with gadoxetic acid can affect laparotomies for pancreatic cancer surgery. |
No results stated in abstract. |
4 |
| 30. Kawakami S, Fukasawa M, Shimizu T, et al. Diffusion-weighted image improves detectability of magnetic resonance cholangiopancreatography for pancreatic ductal adenocarcinoma concomitant with intraductal papillary mucinous neoplasm. Medicine (Baltimore). 98(47):e18039, 2019 Nov. |
Observational-Dx |
38 patients |
To clarify the utility of magnetic resonance cholangiopancreatography (MRCP) and the additional value of diffusion-weighted imaging (DWI) in diagnosing pancreatic ductal adenocarcinoma (PDAC) concomitant with intraductal papillary mucinous neoplasm (IPMN). |
Diagnostic capability and interobserver agreement were assessed by using receiver operating characteristics curve (Az) analysis and weighted kappa statistics.Az values for the 2 observers were 0.834 and 0.821 for MRCP alone and 0.964 and 0.926 for the combined MRI (P < .001 and P < .001), respectively. The sensitivity of MRCP alone was 61% (23/38), with both observers failing to diagnose PDACs located at the end of tail or away from the pancreatic duct. Meanwhile, with combined MRI, sensitivity was significantly increased for both observers (61% to 92%, P = .002; 61% to 87%, P = .004). Moreover, the interobserver agreement was higher with combined MRI (kappa = 0.85) than MRCP alone (kappa = 0.59). |
3 |
| 31. Kulkarni NM, Soloff EV, Tolat PP, et al. White paper on pancreatic ductal adenocarcinoma from society of abdominal radiology's disease-focused panel for pancreatic ductal adenocarcinoma: Part I, AJCC staging system, NCCN guidelines, and borderline resectable disease. [Review]. Abdom Radiol. 45(3):716-728, 2020 03. |
Review/Other-Dx |
N/A |
To review the most current AJCC staging (8th edition), NCCN guidelines (version 2.2019-April 9, 2019), and challenges and controversies in borderline resectable PDA. |
No results stated in the abstract. |
4 |
| 32. Nakahodo J, Kikuyama M, Fukumura Y, et al. Focal pancreatic parenchyma atrophy is a harbinger of pancreatic cancer and a clue to the intraductal spreading subtype. Pancreatology. 22(8):1148-1158, 2022 Dec. |
Review/Other-Dx |
170 patients |
To clarify the incidence of FPPA and the clinicopathological features of PDAC with FPPA before diagnosis. |
FPPA was identified in 47/170 (28%) patients before PDAC diagnosis and in 2/51 (4%) patients in the control group (P < 0.01). The median duration from FPPA detection to diagnosis was 35 (interquartile range [IQR]:16-63) months. In 24/47 (51%) patients with FPPA, the atrophic area resolved. The lesion was in the head and body/tail in 7/40 and 67/56 of the patients with (n = 47) and without FPPA (n = 123), respectively (P < 0.001). Histopathologically confirmed non-invasive lesions in the main pancreatic duct and a positive surgical margin in the resected specimens occurred in 53% vs. 21% (P = 0.078) and 29% vs. 3% (P = 0.001) of the groups, respectively. The PDAC patients with FPPA accompanied by a malignant pancreatic resection margin had high-grade pancreatic intraepithelial neoplasia. |
4 |
| 33. Kurita A, Mori Y, Someya Y, et al. High signal intensity on diffusion-weighted magnetic resonance images is a useful finding for detecting early-stage pancreatic cancer. Abdominal Radiology. 46(10):4817-4827, 2021 10. |
Observational-Dx |
37 patients |
To evaluate novel imaging findings that may contribute to early detection. |
Twenty patients had confirmed malignancy (cancer group) and 17 did not (non-cancer group). Age, MPD stricture location, and PDAC risk factors were similar, but the sex predominance and symptom rate differed between the two groups. In the cancer group, 17 patients were diagnosed by cytology and three by clinical symptoms. CECT, MRI, and endoscopic ultrasonography (EUS) revealed no solid tumors in either group. CECT revealed no significant differences between groups. Diffusion-weighted MRI revealed significant differences in the signal intensity between groups. EUS detected indistinct and small hypoechoic areas in 70% and 41.2% of patients in the cancer and non-cancer groups, respectively. In the cancer group, 11 were diagnosed with cancer at the first indication, and nine were diagnosed at follow-up; the prognosis did not differ between these two subgroups. |
3 |
| 34. Kim M, Mi Jang K, Kim SH, et al. Diagnostic accuracy of diffusion restriction in intraductal papillary mucinous neoplasm of the pancreas in comparison with "high-risk stigmata" of the 2012 international consensus guidelines for prediction of the malignancy and invasiveness. Acta Radiologica. 58(10):1157-1166, 2017 Oct. |
Observational-Dx |
132 patients |
To evaluate the diagnostic accuracy of diffusion restriction in IPMNs for prediction of malignancy and invasiveness in comparison with high-risk stigmata of 2012 ICG. |
The presence of diffusion restriction in IPMNs was the only independent imaging parameter for prediction of malignancy (odds ratio [OR], 11.98; 95% confidence interval [CI], 3.60-39.87; P < 0.001) and invasiveness (OR, 17.92; 95% CI, 3.91-82.03; P < 0.001) on multivariate analysis. The diagnostic accuracy and specificity of diffusion restriction were significantly improved compared to high-risk stigmata of 2012 ICG to prediction of malignant ( P = 0.006 and P < 0.001, respectively) or invasive IPMNs ( P = 0.009 and P = 0.015, respectively). |
4 |
| 35. Heid I, Steiger K, Trajkovic-Arsic M, et al. Co-clinical Assessment of Tumor Cellularity in Pancreatic Cancer. Clin Cancer Res. 23(6):1461-1470, 2017 Mar 15. |
Review/Other-Dx |
N/A |
To aim the noninvasive detection of PDAC groups, relevant for future personalized approaches. |
No results stated in abstract. |
4 |
| 36. Chen J, Liu S, Tang Y, et al. Diagnostic performance of diffusion MRI for pancreatic ductal adenocarcinoma characterisation: A meta-analysis. Eur J Radiol. 139:109672, 2021 Jun. |
Meta-analysis |
29 studies; 1579 patients |
To assess the diagnostic performance of intravoxel incoherent motion (IVIM) and diffusion-weighted imaging (DWI) for characterising pancreatic ductal adenocarcinoma (PDAC). |
Twenty-nine studies involving 1579 participants were included, of which 26 evaluated the apparent diffusion coefficient (ADC) and eight evaluated IVIM, with five evaluating both ADC and IVIM. Pooled sensitivity and specificity of ADC were 83 % (95 % CI, 76 %-88 %, I(2) = 86 %) and 85 % (95 % CI, 79 %-90 %, I(2) = 77 %), respectively, and AUC was 0.91 (95 % CI, 0.88-0.93). The perfusion fraction had the highest diagnostic accuracy in the IVIM model; the pooled sensitivity, specificity, and AUC were 87 % (95 % CI, 81 %-92 %, I(2) = 45 %), 88 % (95 % CI, 77 %-94 %, I(2) = 57 %), and 0.93 (95 % CI, 0.91-0.95), respectively. The pooled sensitivity, specificity and AUC for the tissue diffusion coefficient were 74 % (95 % CI, 55 %-87 %, I(2) = 87 %), 69 % (95 % CI, 52 %-82 %, I(2) = 73 %), and 0.77 (95 % CI, 0.73-0.81), respectively. And the pooled sensitivity, specificity, and AUC for the pseudodiffusion coefficient were 89 % (95 % CI, 77 %-96 %, I(2) = 79 %), 74 % (95 % CI, 60 %-84 %, I(2) = 78 %), and 0.88(95 %CI,0.85-0.91), respectively. Meta-regression analyses revealed that study design (specificity, P<0.01), region-of-interest delineation (sensitivity, P = 0.02;specificity, P = 0.03), field strength (sensitivity, P<0.01), and thickness (sensitivity, P<0.01; specificity, P = 0.01) were sources of ADC heterogeneity. |
Good |
| 37. Sighinolfi M, Quan SY, Lee Y, et al. Fukuoka and AGA Criteria Have Superior Diagnostic Accuracy for Advanced Cystic Neoplasms than Sendai Criteria. Digestive Diseases & Sciences. 62(3):626-632, 2017 03. |
Observational-Dx |
209 patients |
To compare the American Gastroenterological Association guidelines (AGA criteria), the 2012 (Fukuoka criteria), and 2006 (Sendai criteria) International Consensus Guidelines for the diagnosis of advanced pancreatic cystic neoplasms. |
A total of 209 patients were included. Both the AGA and Fukuoka criteria had a higher diagnostic accuracy for advanced neoplastic cysts than the Sendai criteria: AGA ROC 0.76 (95% CI 0.69-0.81), Fukuoka ROC 0.78 (95% CI 0.74-0.82), and Sendai ROC 0.65 (95% CI 0.61-0.69) (p < 0.0001). There was no difference between the Fukuoka and the AGA criteria. While the sensitivity was higher in the Fukuoka criteria compared to the AGA criteria (97.7 vs. 88.6%), the specificity was higher in the AGA criteria compared to the Fukuoka criteria (62.4 vs. 58.2%). |
4 |
| 38. Hoffman DH, Ream JM, Hajdu CH, Rosenkrantz AB. Utility of whole-lesion ADC histogram metrics for assessing the malignant potential of pancreatic intraductal papillary mucinous neoplasms (IPMNs). Abdominal Radiology. 42(4):1222-1228, 2017 04. |
Observational-Dx |
18 patients |
To evaluate whole-lesion ADC histogram metrics for assessing the malignant potential of pancreatic intraductal papillary mucinous neoplasms (IPMNs), including in comparison with conventional MRI features. |
Whole-lesion ADC histogram metrics demonstrating significant differences between benign and malignant IPMNs were: entropy (5.1 +/- 0.2 vs. 5.4 +/- 0.2; p = 0.01, AUC = 86%); mean of the bottom 10th percentile (2.2 +/- 0.4 vs. 1.6 +/- 0.7; p = 0.03; AUC = 81%); and mean of the 10-25th percentile (2.8 +/- 0.4 vs. 2.3 +/- 0.6; p = 0.04; AUC = 79%). The overall mean ADC, skewness, and kurtosis were not significantly different between groups (p >/= 0.06; AUC = 50-78%). For entropy (highest performing histogram metric), an optimal threshold of >5.3 achieved a sensitivity of 100%, a specificity of 70%, and an accuracy of 83% for predicting malignancy. No significant difference (p = 0.18-0.64) was observed between benign and malignant IPMNs for cyst size >/=3 cm, adjacent main-duct dilatation, or mural nodule. At multivariable analysis of entropy in combination with all other ADC histogram and conventional MRI features, entropy was the only significant independent predictor of malignancy (p = 0.004). |
3 |
| 39. Min SK, You Y, Choi DW, et al. Prognosis of pancreatic head cancer with different patterns of lymph node metastasis. J Hepatobiliary Pancreat Sci. 29(9):1004-1013, 2022 Sep. |
Observational-Dx |
585 patients who received pancreatic head cancer surgery diagnosed as PDAC |
To find the patterns of nodal involvement and to reveal its clinical significance to overall survival (OS). |
LNM in peripancreatic area was the most common (88.7%). In the multivariate analysis, T stage, nuclear differentiation, adjuvant treatment, and the G2 and G3 were independent risk factors for OS (G2 over G1, HR 1.384, 95% CI 1.046-1.802; P = .036 and G3 over G1, HR 2.383, 95% CI 1.378-4.103; P = .001). G3 showed worse OS than G2 (P = .006). In the N1 status, LNM to the pericholedochal (PC) and superior mesenteric artery (SMA) areas resulted in worse OS than the G2 (P = .011 and P = .019). |
4 |
| 40. Dallongeville A, Corno L, Silvera S, Boulay-Coletta I, Zins M. Initial Diagnosis and Staging of Pancreatic Cancer Including Main Differentials. [Review]. Semin Ultrasound CT MR. 40(6):436-468, 2019 Dec. |
Review/Other-Dx |
N/A |
To describe the diagnostic imaging options that diagnose and stage pancreatic adenocarcinoma. |
No results stated in abstract. |
4 |
| 41. Bailey JJ, Ellis JH, Davenport MS, et al. Value of pelvis CT during follow-up of patients with pancreatic adenocarcinoma. Abdom Radiol. 42(1):211-215, 2017 01. |
Observational-Dx |
247 patients |
To determine the frequency in which the pelvis component of an abdominopelvic CT provides information that would influence clinical management in two separate groups of patients: those with previously resected pancreatic ductal adenocarcinoma (PDA) and those with locally advanced unresectable PDA. |
No subjects who had undergone pancreaticoduodenectomy had an isolated pelvic metastasis on follow-up imaging (0%; 95% CI 0-2.38, p = 0.0004); 33 had metastatic disease in the abdomen, and 120 had no or equivocal evidence of abdominopelvic metastatic disease. One subject with locally advanced unresectable PDA had a possible isolated pelvic metastasis on follow-up imaging (1.1%; 95% CI 0.03-5.79, p = 0.048); 20 had metastatic disease in the abdomen, and 73 had no or equivocal evidence of abdominopelvic metastatic disease. |
3 |
| 42. Soloff EV, Al-Hawary MM, Desser TS, Fishman EK, Minter RM, Zins M. Imaging Assessment of Pancreatic Cancer Resectability After Neoadjuvant Therapy: AJR Expert Panel Narrative Review. [Review]. AJR Am J Roentgenol. 218(4):570-581, 2022 04. |
Review/Other-Dx |
N/A |
To provide update on the imaging assessment of pancreatic cancer resectability after NAT. |
No results stated in abstract. |
4 |
| 43. Yeh R, Dercle L, Garg I, Wang ZJ, Hough DM, Goenka AH. The Role of 18F-FDG PET/CT and PET/MRI in Pancreatic Ductal Adenocarcinoma. [Review]. Abdom Radiol. 43(2):415-434, 2018 02. |
Review/Other-Dx |
N/A |
To describe the role of 18F-FDG PET/CT and PET/MRI in Pancreatic Ductal Adenocarcinoma. |
No results stated in abstract. |
4 |
| 44. Gnanasegaran G, Agrawal K, Wan S. 18F-Fluorodeoxyglucose-PET-Computerized Tomography and non-Fluorodeoxyglucose PET-Computerized Tomography in Hepatobiliary and Pancreatic Malignancies. [Review]. PET clinics. 17(3):369-388, 2022 Jul. |
Review/Other-Dx |
N/A |
To discuss the advantages and limitations of FDG and non-FDG PET-CT in the management of patients with hepatobiliary and pancreatic cancers. |
No results stated in abstract. |
4 |
| 45. Moon D, Kim H, Han Y, et al. Preoperative carbohydrate antigen 19-9 and standard uptake value of positron emission tomography-computed tomography as prognostic markers in patients with pancreatic ductal adenocarcinoma. J Hepatobiliary Pancreat Sci. 29(10):1133-1141, 2022 Oct. |
Observational-Dx |
189 patients |
To evaluate clinical usefulness of preoperative carbohydrate antigen and preoperative standard uptake value in 18F-fluorodeoxyglucose positron emission tomography as predictive biological markers for resectable pancreatic ductal adenocarcinoma. |
The median duration of OS was 26 months, and the 5-year survival rate was 22.4%. The optimal cutoff values for CA19-9 level was 150 U/mL and SUVmax was 5.5. When subjects were divided into three groups according to the combination of CA19-9 level and SUVmax from C-tree (high-risk group, CA19-9 > 150 U/mL and SUVmax > 5.5; intermediate-risk group, CA19-9 </= 150 U/mL and SUVmax > 5.5 or CA19-9 > 150 U/mL and SUVmax </= 5.5; and low-risk group, CA19-9 </= 150 U/mL and SUVmax </= 5.5), there was a significant 5YSR difference (5.6%, 24.3%, and 36.5%, P < .001). The multivariate analysis revealed high SUVmax, high preoperative CA19-9 level, venous invasion, and adjuvant chemotherapy were prognostic factors of OS. |
3 |
| 46. Chikamoto A, Inoue R, Komohara Y, et al. Preoperative High Maximum Standardized Uptake Value in Association with Glucose Transporter 1 Predicts Poor Prognosis in Pancreatic Cancer. Ann Surg Oncol. 24(7):2040-2046, 2017 Jul. |
Observational-Dx |
93 patients |
To evaluate the relationship between Glut-1 expression and FDG accumulation to determine the usefulness of FDG-PET for prediction of long-term outcomes of pancreatic cancer. |
Glut-1 was positive in 69 patients (50%). The median relapse-free and overall survival times were significantly shorter in the Glut-1-positive group (11 vs. 22 months, respectively) than in the Glut-1-negative group (23 vs. 42 months, respectively). The cSUVmax was significantly associated with long-term survival. The relapse-free and overall survival rates were significantly poorer in the high-cSUVmax group than in the low-cSUVmax group. Glut-1 expression was associated with cSUVmax accumulation. In the multivariate Cox regression analysis using forward stepwise selection, male gender, positive lymph node metastases, high CA19-9, and high cSUVmax were identified as independent prognostic factors for pancreatic cancer. |
3 |
| 47. Zeng P, Ma L, Liu J, Song Z, Liu J, Yuan H. The diagnostic value of intravoxel incoherent motion diffusion-weighted imaging for distinguishing nonhypervascular pancreatic neuroendocrine tumors from pancreatic ductal adenocarcinomas. Eur J Radiol. 150:110261, 2022 May. |
Observational-Dx |
63 patients with PNETs (35 nonhypervascular PNETs and 28 hypervascular PNETs) and 164 patients with PDACs |
To primarily evaluate the diagnostic performance of the monoexponential and intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI) models for differentiating between nonhypervascular pancreatic neuroendocrine tumors (PNETs) and pancreatic ductal adenocarcinomas (PDACs). |
All DWI parameters values showed good to excellent intra- and interobserver agreements (ICC = 0.743-0.873). Nonhypervascular PNETs had significantly lower ADC and D, but significantly higher f than PDACs (P = 0.005, P < 0.001 and P < 0.001, respectively). ADC, D and f of nonhypervascular PNETs were lower than hypervascular PNETs (P = 0.001, <0.001 and 0.093, respectively). D* of nonhypervascular PNETs showed no statistically significant differences with PDACs and hypervascular PNETs (P = 0.809 and 0.420). D showed a higher area under the curve (AUC), followed by ADC and f (AUC = 0.885, 0.665 and 0.740, respectively) in differentiating nonhypervascular PNETs from PDACs. |
3 |
| 48. Xiao B, Jiang ZQ, Hu JX, Zhang XM, Xu HB. Differentiating pancreatic neuroendocrine tumors from pancreatic ductal adenocarcinomas by the "Duct-Road Sign": A preliminary magnetic resonance imaging study. Medicine (Baltimore). 98(35):e16960, 2019 Aug. |
Observational-Dx |
75 masses |
To assess the duct-road sign and tumor-to-duct ratio (TDR) in MRI for differentiating pancreatic neuroendocrine tumors (PNETs) from pancreatic ductal-adenocarcinomas (PDACs). |
The prevalence of duct-road sign in PNETs was higher than that for PDACs (84% vs 0%; P < .001). A strong correlation (r = 0.884, P < .001) was observed between MRI for PNETs and the frequency of this sign. Performance characteristics of the duct-road sign in MRI for PNET diagnosis were sensitivity (84%, [21 of 25]), specificity (100%, [53 of 53]), positive predictive value (100%, [21 of 21]), negative predictive value (92.9%, [53 of 57]), and accuracy (94.8%, [74 of 78]). In the intention-to-diagnose analysis, the corresponding values were 67.7% (21 of 31), 100% (53 of 53), 100% (21 of 21), 84.1% (53 of 63), and 88.1% (74 of 84). The TDR in PNETs was observed to be greater than that in PDACs (14.6 +/- 9.3 vs 6.9 +/- 3.8, P = .001). TDR with a cut-off value of 7.7 had high sensitivity (84%) and specificity (66%) with area under curve (0.802, 95% CI: 0.699, 0.904; P < .001) for distinguishing PNETs from PDACs.The presence of duct-road sign and TDR > 7.7 on MRI may assist in diagnosis for PNET instead of PDAC. |
3 |
| 49. Shi YJ, Li XT, Zhang XY, et al. Non-gaussian models of 3-Tesla diffusion-weighted MRI for the differentiation of pancreatic ductal adenocarcinomas from neuroendocrine tumors and solid pseudopapillary neoplasms. Magn Reson Imaging. 83:68-76, 2021 11. |
Observational-Dx |
148, 56, and 60 patients with PDAC, PNET, and SPN, respectively |
To assess the MRI performance in differentiating pancreatic ductal adenocarcinomas (PDACs), from solid pseudopapillary neoplasms (SPNs) and pancreatic neuroendocrine tumors (PNETs) using non-gaussian diffusion-weighted imaging models. |
For differentiating PDACs from SPNs, f and MK values were used to establish a diagnostic model with areas under the receiver operating characteristic curves (AUCs) of 0.92 and 0.89 in the primary and validation groups, respectively. For distinguishing PDACs from PNETs, alpha and MK values were used to establish a diagnostic model with AUCs of 0.87 and 0.86 in the primary and validation groups, respectively. The accuracy rate of the subjective evaluation with the assistance of non-gaussian DWI models for differentiating PDAC from SPNs and PNETs were higher than that of subjective diagnosis alone (P < 0.05). |
4 |
| 50. Jeon SK, Lee JM, Joo I, et al. Magnetic resonance with diffusion-weighted imaging improves assessment of focal liver lesions in patients with potentially resectable pancreatic cancer on CT. European Radiology. 28(8):3484-3493, 2018 Aug. |
Observational-Dx |
167 patients |
To investigate added value of MRI to preoperative staging MDCT for evaluation of focal liver lesions (FLLs) in potentially resectable pancreatic ductal adenocarcinomas (PDACs). |
Reader-averaged figure-of-merit (FOM) of the combined set was significantly higher than that of MDCT alone (0.94 vs. 0.86, p=.028). In the negative-on-CT group, the diagnostic yield of MRI was 1.5-2.3% (2/133 and 3/133 for readers 1 and 2, respectively). In the indeterminate-on-CT group, MRI yield was 10.5-13.6% (2/19 and 3/22) and in patients with suspicious-metastasis-on-CT, 8.3-26.7% (1/12 and 4/15). All lesions with false-positive and false-negative CT findings were </=1 cm. |
3 |
| 51. Kim HJ, Park MS, Lee JY, et al. Incremental Role of Pancreatic Magnetic Resonance Imaging after Staging Computed Tomography to Evaluate Patients with Pancreatic Ductal Adenocarcinoma. Cancer Res. Treat.. 51(1):24-33, 2019 Jan. |
Observational-Dx |
298 patients |
To investigate the impact of contrast enhanced pancreatic magnetic resonance imaging (MRI) in resectability and prognosis evaluation after staging computed tomography (CT) in patients with pancreatic ductal adenocarcinoma (PDA). |
Staging was changed from resectable on CT to unresectable state on MRI in 14.4% of (31 of 216 patients) patients of the CT+MR group. The overall survival and recurrence-free survival rates were not significantly different between the two groups (p=0.162 and p=0.721, respectively). The median time to liver metastases after curative surgery in the CT+MR group (9.9 months) was significantly longer than that in the CT group (4.2 months) (p=0.011). |
3 |
| 52. Tanaka S, Fukuda J, Nakao M, et al. Effectiveness of Contrast-Enhanced Ultrasonography for the Characterization of Small and Early Stage Pancreatic Adenocarcinoma. Ultrasound Med Biol. 46(9):2245-2253, 2020 09. |
Observational-Dx |
200 patients |
To evaluate the effectiveness of contrast-enhanced ultrasonography for the characterization of small and early stage pancreatic adenocarcinoma. |
The sensitivities of contrast-enhanced ultrasonography and contrast-enhanced CT to characterize adenocarcinoma were 97.0% and 77.0% (p < 0.0001) for all 100 adenocarcinoma cases, 100% and 76.7% (p?=?0.0016) for 43 small (</=20 mm) cancers, 100% and 58.3% (p?=?0.0253) for 12 smaller (</=10 mm) cancers and 100% and 72.2% (p?=?0.0016) for 36 stage IA cancers, respectively. |
3 |
| 53. Wang ZJ, Arif-Tiwari H, Zaheer A, et al. Therapeutic response assessment in pancreatic ductal adenocarcinoma: society of abdominal radiology review paper on the role of morphological and functional imaging techniques. [Review]. Abdom Radiol. 45(12):4273-4289, 2020 12. |
Review/Other-Dx |
N/A |
To provide an overview of current therapy options for PDA, highlight several morphological imaging findings that may be helpful to reduce over-staging following neoadjuvant therapy, and discuss a number of emerging imaging, and non-imaging, tools that have shown promise in providing a more precise quantification of disease burden and treatment response in PDA. |
No results stated in abstract. |
4 |
| 54. Kim JH, Eun HW, Kim KW, et al. Diagnostic performance of MDCT for predicting important prognostic factors in pancreatic cancer. Pancreas. 42(8):1316-22, 2013 Nov. |
Observational-Dx |
111 patients |
To investigate diagnostic accuracy of MDCT for determining tumor stage, node metastasis, tumor size, vascular invasion, and perineural invasion prognostic factors. |
Statistically, tumor size on specimens (3.4 +/- 1.46 cm) is larger than tumor size on MDCT (3.2 +/- 1.41 cm; P = 0.001). The diagnostic accuracy rates for tumor stage were 82.9% and 77.5%, with moderate agreement (kappa = 0.732). The accuracy rates for node metastasis were 59.5% and 55.0%, with fair agreement (kappa = 0.597). The diagnostic accuracy rates for vascular invasion were 94% and 92%. The areas under the curve for perineural invasion were 0.733 and 0.66 (P = 0.069), with moderate agreement (kappa = 0.77). |
2 |
| 55. Zhang L, Zhang ZY, Ni JM, et al. Prediction of Vascular Invasion Using a 3-Point Scale Computed Tomography Grading System in Pancreatic Ductal Adenocarcinoma: Correlation With Surgery. J Comput Assist Tomogr. 41(3):394-400, 2017 May/Jun. |
Observational-Dx |
55 patients |
To evaluate the correlation between a 3-point scale multidetector computed tomography (MDCT) grading system and surgical exploration in predicting vascular invasion and resectability in patients with pancreatic ductal adenocarcinoma (PDA). |
Tumor location was correctly identified in all patients including 2 isodense lesions by means of nCTCP. The mean sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MDCT were 92%, 83%, 95%, 78%, and 90%, respectively, in predicting tumor resectability compared with surgery and pathology and with good agreement (kappa = 0.72-0.77). A correlation was observed between CT and surgical grade in predicting vascular invasion on a per-vessel basis, and the agreement presented as good to excellent (kappa = 0.66-1.00). |
3 |
| 56. Camacho A, Fang J, Cohen MP, Raptopoulos V, Brook OR. Split-bolus pancreas CTA protocol for local staging of pancreatic cancer and detection and characterization of liver lesions. Abdom Radiol. 43(2):340-350, 2018 02. |
Observational-Dx |
82 patients |
To validate the use of a split-bolus pancreas CTA protocol for local staging of pancreatic cancer and to evaluate its ability to detect and characterize liver lesions. |
There were 82 pancreatic cancer patients with a total of 91 liver findings. Tumor conspicuity and CNR were 60.8 +/- 35.1 HU and 8.0 +/- 5.8 for the pancreatic lesions and 58 +/- 34.7 HU and 9.7 +/- 6.3 for the liver lesions, respectively. The accuracy, sensitivity, and specificity of the split-bolus protocol for the hepatic findings were correspondingly 89/91 (97.8%, 95% CI 92.3-99.4), 58/60 (96.7%, 95% CI 88.6-99.1), and 33/33 (100%, 95% CI 89.6-100). The subjective image quality ratings were optimal in more than 89% of the cases for various structures, with no non-diagnostic ratings. |
2 |
| 57. Yu H, Huang Z, Li M, et al. Differential Diagnosis of Nonhypervascular Pancreatic Neuroendocrine Neoplasms From Pancreatic Ductal Adenocarcinomas, Based on Computed Tomography Radiological Features and Texture Analysis. Acad Radiol. 27(3):332-341, 2020 03. |
Observational-Dx |
40 nonhypervascular PNENs and 80 PDACs |
To determine computed tomography (CT) radiological features and texture features that are rewarding in differentiating nonhypervascular pancreatic neuroendocrine neoplasms (PNENs) from pancreatic ductal adenocarcinomas (PDACs). |
In total, 40 nonhypervascular PNENs and 80 PDACs were evaluated. Maximum diameter on axial section, margin, calcification, vascularity in the tumor, and tumor heterogeneity were significantly different between PDACs and nonhypervascular PNENs. Multivariate analysis showed well-defined tumor margin (odds ratio: 21.0) and presence of calcification (odds ratio: 4.4) were significant predictors of nonhypervascular PNENs. The area under the receiver operating characteristic curve of the radiological feature model, AP texture model, and PVP texture model were 0.780, 0.855, and 0.929, respectively, based on logistic regression. |
3 |
| 58. Sandrasegaran K, Lin Y, Asare-Sawiri M, Taiyini T, Tann M. CT texture analysis of pancreatic cancer. Eur Radiol. 29(3):1067-1073, 2019 Mar. |
Observational-Dx |
60 patients |
To investigate the value of CT texture analysis (CTTA) in predicting prognosis of unresectable pancreatic cancer. |
The median overall and progression-free survivals of cohort were 13.3 and 7.8 months, respectively. On multivariate Cox proportional hazard regression analysis, presence of metastatic disease at presentation had the highest association with overall survival (p = 0.003-0.05) and progression-free survival (p < 0.001 to p = 0.004). MPP at medium spatial filter was significantly associated with poor overall survival (p = 0.04). On Kaplan-Meier survival analysis of CTTA parameters at medium spatial filter, MPP of more than 31.625 and kurtosis of more than 0.565 had significantly worse overall survival (p = 0.036 and 0.028, respectively). |
3 |
| 59. Reinert CP, Baumgartner K, Hepp T, Bitzer M, Horger M. Complementary role of computed tomography texture analysis for differentiation of pancreatic ductal adenocarcinoma from pancreatic neuroendocrine tumors in the portal-venous enhancement phase. Abdom Radiol. 45(3):750-758, 2020 03. |
Observational-Dx |
53 patients (66.1 +/- 8.6y) with PDAC and 42 patients (65.5 +/- 12.2y) with PNEN |
To assess the role of CT-texture analysis (CTTA) for differentiation of pancreatic ductal adenocarcinoma (PDAC) from pancreatic neuroendocrine neoplasm (PNEN) in the portal-venous phase as compared with visual assessment and tumor-to-pancreas attenuation ratios. |
8/92 (8.6%) highly significant (p < 0.005) discriminatory textural features between PDAC and PNEN were identified including the 1st order features "median," "total energy," "energy," "10th percentile," "90th percentile," "minimum," "maximum," and the 2nd order feature "Gray-Level co-occurrence Matrix (GLCM) Informational Measure of Correlation (Imc2)." In PNEN, the higher order feature "GLSZM Small Area High Gray-Level Emphasis" proved significantly higher in G1 compared to G2/3 tumors (p < 0.05). The tumor/parenchyma ratios as well as the visual assessment into hypo-/iso-/hyperdense or homogeneous/heterogeneous did not significantly differ between PDAC and PNEN. |
3 |
| 60. Qureshi TA, Gaddam S, Wachsman AM, et al. Predicting pancreatic ductal adenocarcinoma using artificial intelligence analysis of pre-diagnostic computed tomography images. Cancer Biomarkers: Section A of Disease Markers. 33(2):211-217, 2022.Cancer Biomark. 33(2):211-217, 2022. |
Observational-Dx |
72 patients |
To stratify high risk individuals for PDAC by identifying predictive features in pre-diagnostic abdominal Computed Tomography (CT) scans. |
The system achieved an average classification accuracy of 86% on the external dataset. |
4 |
| 61. Patel BN, Olcott EW, Jeffrey RB. Duodenal invasion by pancreatic adenocarcinoma: MDCT diagnosis of an aggressive imaging phenotype and its clinical implications. [Review]. Abdom Radiol. 43(2):332-339, 2018 02. |
Review/Other-Dx |
N/A |
To focus on the former highlighting the summary of literature supporting duodenal invasion as a surrogate for aggressive disease as well as review its MDCT imaging features. |
No results stated in abstract. |
4 |
| 62. Guo C, Zhuge X, Wang Q, et al. The differentiation of pancreatic neuroendocrine carcinoma from pancreatic ductal adenocarcinoma: the values of CT imaging features and texture analysis. Cancer Imaging. 18(1):37, 2018 Oct 17. |
Observational-Dx |
32 patients |
To demonstrate the value of computed tomography (CT) imaging features and texture analysis to differentiate PNEC from PDAC. |
More PNEC than PDAC had well-defined margins (57.1% vs 25.0%, p = 0.04). Parenchymal atrophy was more common in PDAC than in PNEC (67.9% vs 28.1%, p = 0.02). CT attenuation values (HU) and contrast ratios of PNEC inthe arterial and portal phases were higher than those of PDAC (p < 0.05 or 0.01). Entropy was lower and uniformity was higher in PNEC compare to PDAC at the arterial phase (p < 0.05). Contrast ratio showed the highest area under curve (AUC) for differentiating PNEC from PDAC (AUC = 0.98-0.99). Entropy and uniformity also showed an acceptable AUC (0.71-0.72). |
3 |
| 63. Chu LC, Park S, Kawamoto S, et al. Utility of CT Radiomics Features in Differentiation of Pancreatic Ductal Adenocarcinoma From Normal Pancreatic Tissue. AJR Am J Roentgenol. 213(2):349-357, 2019 08. |
Observational-Dx |
190 patients |
to determine the utility of radiomics features in differentiating CT cases of pancreatic ductal adenocarcinoma (PDAC) from normal pancreas. |
Mean tumor size was 4.1 +/- 1.7 (SD) cm. The overall accuracy of the random forest binary classification was 99.2% (124/125), and AUC was 99.9%. All PDAC cases (60/60) were correctly classified. One case from a renal donor was misclassified as PDAC (1/65). The sensitivity was 100%, and specificity was 98.5%. |
3 |
| 64. Choi SH, Kim HJ, Kim KW, et al. DPC4 gene expression in primary pancreatic ductal adenocarcinoma: relationship with CT characteristics. Br J Radiol. 90(1073):20160403, 2017 May. |
Observational-Dx |
163 patients |
To investigate the relationship between CT imaging findings and DPC4 gene expression and to determine the prognostic value of DPC4 gene expression to predict overall survival in patients with pancreatic ductal adenocarcinoma. |
Between DPC4-expression group (n = 75) and DPC4-non-expression group (n = 88), three CT findings (i.e., tumour margin, peripancreatic infiltration, and the presence of background intraductal pancreatic mucinous neoplasm) were significantly different in univariate analysis. Of these, a well-defined tumour margin was significantly associated with DPC4-expression tumour (adjusted odds ratio = 2.06; p = 0.032) in multivariate analysis. Of the total 163 patients, the mean overall survival of the DPC4-expression group was significantly longer than that of the DPC4-non-expression group (30.0 vs 22.0 months; p = 0.049). Of the 150 T3 tumours, the presence of well-defined tumour margins was also a significant CT finding (adjusted odd ratio = 2.00; p = 0.044) in multivariate analysis. However, of 131 patients with T3 tumour and R0 resection, the overall survival period of the DPC4-expression group was not significantly different from that of the DPC4-non-expression group (24.0 vs 22.0 months; p = 0.240). |
3 |
| 65. Khalvati F, Zhang Y, Baig S, et al. Prognostic Value of CT Radiomic Features in Resectable Pancreatic Ductal Adenocarcinoma. Sci. rep.. 9(1):5449, 2019 04 01. |
Observational-Dx |
98 patients |
To assess the reproducibility and prognostic value of CT-derived radiomic features for resectable pancreatic ductal adenocarcinoma (PDAC). |
Radiomic features were extracted using PyRadiomics library and those with weak inter-reader reproducibility were excluded. Through Cox regression models, significant features were identified in the training cohort and retested in the validation cohort. Significant features were then fused via Cox regression to build a single radiomic signature in the training cohort, which was validated across readers in the validation cohort. Two radiomic features derived from Sum Entropy and Cluster Tendency features were both robust to inter-reader reproducibility and prognostic of OS across cohorts and readers. The radiomic signature showed prognostic value for OS in the validation cohort with hazard ratios of 1.56 (P = 0.005) and 1.35 (P = 0.022), for the first and second reader, respectively. |
3 |
| 66. Borhani AA, Dewan R, Furlan A, et al. Assessment of Response to Neoadjuvant Therapy Using CT Texture Analysis in Patients With Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma. AJR Am J Roentgenol. 214(2):362-369, 2020 02. |
Observational-Dx |
39 patients |
To assess the correlation between CT-derived texture features of pancreatic ductal adenocarcinoma (PDAC) and histologic and biochemical markers of response to neoadjuvant treatment as well as disease-free survival in patients with potentially resectable PDAC. |
Pretreatment mean positive pixel (MPP) at fine- and medium-level filtration, pretreatment kurtosis at medium-level filtration, changes in kurtosis, and pretreatment tumor SD were statistically different between patients with no or poor histologic response and favorable histologic response (p < 0.05). Changes in skewness and kurtosis at medium-level filtration significantly correlated with biochemical response (p < 0.01). On the basis of multivariate analysis, patients with higher MPP at pretreatment CT were more likely to have favorable histologic response (odds ratio, 1.06; 95% CI, 1.002-1.12). The Cox model for association between textural features and disease-free survival was statistically significant (p = 0.001). |
3 |
| 67. Perik TH, van Genugten EAJ, Aarntzen EHJG, Smit EJ, Huisman HJ, Hermans JJ. Quantitative CT perfusion imaging in patients with pancreatic cancer: a systematic review. [Review]. Abdom Radiol. 47(9):3101-3117, 2022 Sep. |
Meta-analysis |
21 studies |
To evaluate CTP for diagnosis, grading, and treatment assessment of PDAC. |
All studies comparing PDAC with non-tumorous parenchyma found significant CTP-based differences in blood flow (BF) and blood volume (BV). Two studies found significant differences between pathological grades. Two other studies showed that BF could predict neoadjuvant treatment response. A wide variety in kinetic models and acquisition protocol was found among included studies. Quantitative CTP shows a potential benefit in PDAC diagnosis and can serve as a tool for pathological grading and treatment assessment; however, clinical evidence is still limited. |
Good |
| 68. Kim SI, Shin JY, Park JS, et al. Vascular enhancement pattern of mass in computed tomography may predict chemo-responsiveness in advanced pancreatic cancer. Pancreatology. 17(1):103-108, 2017 Jan - Feb. |
Observational-Dx |
101 patients |
To assess vascular enhancement in advanced pancreatic adenocarcinoma with or without liver metastasis in computed tomography (CT) and to analyze the correlation between enhancement patterns and chemo-responsiveness. |
Of the 101 study subjects, 78(77.2%) were assigned to the pancreas responder group mean DeltaHU (+/-SD), 36.7(+/-21.6) and 23(22.8%) to the pancreas non-responder group mean DeltaHU (+/-SD), 20.6(+/-9.9) (p = 0.001 for DeltaHUs). Of the 46 study subjects with liver metastasis, 25(54.3%) were assigned to the liver metastasis responder group mean DeltaHU (+/-SD), 36.9(+/-21.0 and 21(45.7%) to the liver metastasis non-responder group mean DeltaHU (+/-SD), 17.1 (+/-24.0), (p = 0.005 for DeltaHUs). |
3 |
| 69. Shi H, Wei Y, Cheng S, et al. Survival prediction after upfront surgery in patients with pancreatic ductal adenocarcinoma: Radiomic, clinic-pathologic and body composition analysis. Pancreatology. 21(4):731-737, 2021 Jun. |
Observational-Dx |
299 patients |
To investigate the value of radiomic features at contrast-enhanced CT integrated with clinic-pathologic features and body composition measures for predicting survival after upfront surgery in patients with pancreatic ductal adenocarcinoma (PDAC). |
Five independent variables were selected for the radiomics model: radiomics signature, carbohydrate antigen 19-9, skeletal muscle index, histologic grade and postoperative chemotherapy. The radiomics-based model provided better predictive performance (C-index = 0.73; all p < 0.05) than the clinical model without radiomics signature and American Joint Committee on Cancer (AJCC) TNM staging system. Patients were stratified as high-risk and low-risk group by the radiomics model. The KM analysis showed a significant difference between two groups (p < 0.05). |
3 |
| 70. Cassinotto C, Cortade J, Belleannee G, et al. An evaluation of the accuracy of CT when determining resectability of pancreatic head adenocarcinoma after neoadjuvant treatment. Eur J Radiol. 2013;82(4):589-593. |
Observational-Dx |
80 patients |
To evaluate the accuracy of MDCT for determination of resectability R0 after neoadjuvant therapy in patients with pancreatic head adenocarcinoma locally advanced. |
41/42 patients in control group and 31/38 patients in neoadjuvant group finally had curative resection. While resection R0 is similar in both groups (83% and 81%), CT accuracy in determining resectability R0 was significantly decreased in neoadjuvant group (58% versus 83%; p=0.039). CT scan specificity was significantly lower after neoadjuvant therapy (52% versus 88% in control group) due to an overestimation of vascular invasion: 12/31 patients with complete resection in neoadjuvant group were evaluated at high risk of incomplete resection on CT scan. Tumor size tends to be underestimated in control group (-2mm) and overestimated in neoadjuvant group (+10mm). T-staging accuracy was decreased in neoadjuvant group (39% versus 78% in control group; p=0.002). |
2 |
| 71. Ferrone CR, Marchegiani G, Hong TS, et al. Radiological and surgical implications of neoadjuvant treatment with FOLFIRINOX for locally advanced and borderline resectable pancreatic cancer. Ann Surg. 2015;261(1):12-17. |
Observational-Tx |
188 patients |
To evaluate the accuracy of imaging in determining the resectability of PDAC and to determine the surgical and clinicopathologic outcomes of pancreatic resections after neoadjuvant FOLFIRINOX therapy. |
Of 188 patients undergoing resection for PDAC, 40 LA/borderline received FOLFIRINOX and 87 received no neoadjuvant therapy. FOLFIRINOX resulted in a significant decrease in tumor size, yet 19 patients were still classified as LA and 9 as borderline. Despite post-FOLFIRINOX imaging suggesting continued unresectability, 92% had an R0 resection. When compared with no neoadjuvant therapy, FOLFIRINOX resulted in significantly longer operative times (393 vs 300 minutes) and blood loss (600 vs 400 mL), but significantly lower operative morbidity (36% vs 63%) and no postoperative pancreatic fistulas. Length of stay (6 vs 7 days), readmissions (20% vs 30%), and mortality were equivalent (1% vs 0%). On final pathology, the FOLFIRINOX group had a significant decrease in lymph node positivity (35% vs 79%) and perineural invasion (72% vs 95%). Median follow-up was 11 months with a significant increase in overall survival with FOLFIRINOX. |
2 |
| 72. Park SJ, Jang S, Han JK, et al. Preoperative assessment of the resectability of pancreatic ductal adenocarcinoma on CT according to the NCCN Guidelines focusing on SMA/SMV branch invasion. Eur Radiol. 31(9):6889-6897, 2021 Sep. |
Observational-Dx |
368 patients |
To evaluate diagnostic accuracy of CT in determining the resectability of PAC based on 2020 NCCN Guidelines. |
R0 rates were 80.8% (189/234), 67% (71/106), and 10.7% (3/28) for resectable, borderline resectable, and unresectable PAC according to 2020 NCCN Guidelines, respectively (p < 0.001). The estimated 3-year OS was 28.9% for borderline resectable PAC, which was significantly lower than for resectable PAC (43.6%) (p = 0.004) but significantly higher than for unresectable PAC (0.0%) (p < 0.001). R0 rate was significantly lower in patients with unresectable PAC according to 2020 NCCN Guidelines (10.7%, 3/28) than in those with unresectable PAC according to the previous version (31.7%, 20/63) (p = 0.038). In resectable PAC, tumor size >/= 3 cm (p = 0.03) and abutment to portal vein (PV) (p = 0.04) were independently associated with margin-positive resection. |
3 |
| 73. Jeon SK, Lee JM, Lee ES, et al. How to approach pancreatic cancer after neoadjuvant treatment: assessment of resectability using multidetector CT and tumor markers. Eur Radiol. 32(1):56-66, 2022 Jan. |
Observational-Dx |
179 patients |
To investigate clinical and CT factors associated with local resectability in patients with nonmetastatic pancreatic cancers after neoadjuvant chemotherapy +/- radiation therapy (CRT). |
A total of 179 patients (mean age, 62.4 +/- 9.3 years; 92 men) were included. After neoadjuvant CRT, 105 (58.7%) patients received R0 resection, while 74 (41.3%) did not. R0 resection rates were significantly different according to post-CRT CT resectability categories (p < 0.001): 82.8% (48/58), 70.1% (47/67), and 18.5% (10/54) for resectable, borderline resectable, and locally advanced disease, respectively. For post-CRT borderline resectable disease, >/= 50% decrease in CA 19-9 was significantly associated with R0 resection (odds ratio (OR), 3.160; p = 0.02). For post-CRT locally advanced disease, small post-CRT tumor size </= 2 cm (OR, 9.668; p = 0.026) and decreased tumor-arterial contact (OR, 24.213; p = 0.022) were significantly associated with R0 resection. |
3 |
| 74. Tabata K, Nishie A, Shimomura Y, et al. Prediction of pathological response to preoperative chemotherapy for pancreatic ductal adenocarcinoma using 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography. Clin Radiol. 77(6):436-442, 2022 06. |
Observational-Dx |
28 patients |
To determine whether the pathological response to preoperative chemotherapy for pancreatic ductal adenocarcinoma (PDAC) can be predicted using 2-[(18)F]-fluoro-2-deoxy-d-glucose positron-emission tomography (F-18 FDG-PET). |
The mean SUVmax of the response group was higher than that of the non-response group (9.00 +/- 1.78 versus 4.26 +/- 2.35; p<0.001). The optimal cut-off value of SUVmax was 9.28 for distinguishing the two groups. The sensitivity, specificity, and accuracy for the prediction in the response group were 80%, 95.7%, and 92.9%, respectively. |
3 |
| 75. Wang Z, Chen JQ, Liu JL, Qin XG, Huang Y. FDG-PET in diagnosis, staging and prognosis of pancreatic carcinoma: a meta-analysis. World J Gastroenterol. 2013;19(29):4808-4817. |
Meta-analysis |
39 studies |
To investigate the potential role of positron emission tomography (PET) in the diagnosis, staging and prognosis predicting of pancreatic carcinoma (PC). |
A total of 39 studies were included. The pooled sensitivity of PET in diagnosing PC (30 studies, 1582 patients), evaluating N stating (4 studies, 101 patients) and liver metastasis (7 studies, 316 patients) were 0.91 (95%CI: 0.88-0.93), 0.64 (95%CI: 0.50-0.76), and 0.67 (95%CI: 0.52-0.79), respectively; and the corresponding specificity was 0.81 (95%CI: 0.75-0.85), 0.81 (95%CI: 0.25-0.85), and 0.96 (95%CI: 0.89-0.98), respectively. In prognosis analysis (6 studies, 198 patients), significant difference of overall survival was observed between high and low standardized uptake value groups (HR = 2.39, 95%CI: 1.57-3.63). Subgroup analysis showed that PET/CT was more sensitive than PET alone in evaluating liver metastasis of PC, 0.82 (95%CI: 0.48-0.98) and 0.67 (95%CI: 0.52-0.79), respectively. |
M |
| 76. Crippa S, Salgarello M, Laiti S, et al. The role of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in resectable pancreatic cancer. Dig Liver Dis. 46(8):744-9, 2014 Aug. |
Observational-Dx |
72 patients |
To retrospectively assess the value of (18)fluoro-deoxyglucose positron emission tomography/computed tomography in addition to conventional imaging as a staging modality in pancreatic cancer. |
Overall, 21% of patients had a maximum standardized uptake value </= 3, and 60% of those had undergone neoadjuvant treatment (P=0.0001). Furthermore, 11% of patients were spared unwarranted surgery since positron emission tomography/computed tomography detected metastatic disease. All liver metastases were subsequently identified with contrast-enhanced ultrasound. Sensitivity and specificity of positron emission tomography/computed tomography for distant metastases were 78% and 100%. The median CA19.9 concentration was 48.8 U/mL for the entire cohort and 292 U/mL for metastatic patients (P=0.112). |
3 |
| 77. Pergolini I, Crippa S, Salgarello M, et al. SUVmax after (18)fluoro-deoxyglucose positron emission tomography/computed tomography: A tool to define treatment strategies in pancreatic cancer. Dig Liver Dis. 50(1):84-90, 2018 Jan. |
Observational-Dx |
46 patients |
To analyze maximum standard uptake value (SUVmax) after 18FDG-PET/CT as predictor of survival outcomes and method to determine treatment strategies. |
46 patients were included in the analysis. Median follow-up was 27 months (4-67). Patients who recurred within 12 months showed a significantly higher preoperative median SUVmax (8.1 vs 6.1, p=0.039). Receiver operating characteristics (ROC) curves for disease-free survival (DFS) and disease-specific survival (DSS) identified SUVmax of 6.0 as optimal cut-off. Multivariate analysis showed that SUVmax >/= 6.0 was an independent predictor of poor DFS (HR 2.288, p=0.024) and DSS (HR 4.875, p<0.001). The combination of SUVmax >/=6.0 with CA19.9 >/=200U/ml was significantly associated with survival outcomes in comparison to patients without concordantly elevated values. |
3 |
| 78. Gu X, Zhou R, Li C, et al. Preoperative maximum standardized uptake value and carbohydrate antigen 19-9 were independent predictors of pathological stages and overall survival in Chinese patients with pancreatic duct adenocarcinoma. BMC Cancer. 19(1):456, 2019 May 15. |
Observational-Dx |
109 patients |
To analyze whether preoperative maximum standardized uptake value (SUVmax) and carbohydrate antigen 19-9 (CA19-9) levels might provide prognostic information in Chinese patients with pancreatic duct adenocarcinoma (PDAC) after pancreaticoduodenectomy (PD). |
Patients had a mean age of 59 +/- 9.35 years. Females accounted for 38.5%. Mean levels of SUVmax, carcino-embryonic antigen (CEA) and CA19-9 were 5.70 +/- 2.76, 3.95 +/- 4.16ng/mL and 321.62 +/- 780.71kU/L. In univariate Logistic regression analysis, preoperative SUVmax, CEA and CA19-9 levels (p < 0.05 for all) rather than other preoperative variables (p > 0.05 for all) were significantly related to AJCC stages. Multivariate Logistic regression analysis showed that preoperative SUVmax and CA19-9 levels (p < 0.05 for all) rather than other preoperative variables (p > 0.05 for all) were significantly associated with AJCC stages. Mean overall survival (OS) was 21 +/- 14.50 months. In univariate Cox regression analysis, age, SUVmax, CEA and CA19-9 levels before operation (p < 0.05 for all) rather than other preoperative variables (p > 0.05 for all) were significantly related to OS. Multivariate Cox regression analysis showed that age, SUVmax and CA19-9 levels before operation (p < 0.05 for all) rather than other preoperative variables (p > 0.05 for all) were significantly associated with OS. |
4 |
| 79. Ghaneh P, Hanson R, Titman A, et al. PET-PANC: multicentre prospective diagnostic accuracy and health economic analysis study of the impact of combined modality 18fluorine-2-fluoro-2-deoxy-d-glucose positron emission tomography with computed tomography scanning in the diagnosis and management of pancreatic cancer. Health Technology Assessment (Winchester, England). 22(7):1-114, 2018 02.Health Technol Assess. 22(7):1-114, 2018 02. |
Observational-Dx |
589 patients |
To determine the incremental diagnostic accuracy and impact of PET/CT in addition to standard diagnostic work-up in patients with suspected pancreatic cancer. |
Between 2011 and 2013, 589 patients with suspected pancreatic cancer underwent MDCT and PET/CT, with 550 patients having complete data and in-range PET/CT. Sensitivity and specificity for the diagnosis of pancreatic cancer were 88.5% and 70.6%, respectively, for MDCT and 92.7% and 75.8%, respectively, for PET/CT. The maximum standardised uptake value (SUV(max.)) for a pancreatic cancer diagnosis was 7.5. PET/CT demonstrated a significant improvement in relative sensitivity (p = 0.01) and specificity (p = 0.023) compared with MDCT. Incremental likelihood ratios demonstrated that PET/CT significantly improved diagnostic accuracy in all scenarios (p < 0.0002). PET/CT correctly changed the staging of pancreatic cancer in 56 patients (p = 0.001). PET/CT influenced management in 250 (45%) patients. PET/CT stopped resection in 58 (20%) patients who were due to have surgery. The benefit of PET/CT was limited in patients with chronic pancreatitis or other pancreatic tumours. PET/CT was associated with a gain in quality-adjusted life-years of 0.0157 (95% confidence interval -0.0101 to 0.0430). In the base-case model PET/CT was seen to dominate MDCT alone and is thus highly likely to be cost-effective for the UK NHS. PET/CT was seen to be most cost-effective for the subgroup of patients with suspected pancreatic cancer who were thought to be resectable. |
3 |
| 80. Garces-Descovich A, Morrison TC, Beker K, Jaramillo-Cardoso A, Moser AJ, Mortele KJ. DWI of Pancreatic Ductal Adenocarcinoma: A Pilot Study to Estimate the Correlation With Metastatic Disease Potential and Overall Survival. AJR Am J Roentgenol. 212(2):323-331, 2019 02. |
Observational-Dx |
290 patients |
To analyze the relationship between the apparent diffusion coefficient (ADC) of pancreatic ductal adenocarcinoma (PDAC) and the presence or development of metastasis and overall survival (OS). |
Of 48 patients, 10 had metastases at staging MRI, and 12 later developed metastatic disease. Among the latter, the mean time from staging MRI to metastasis was 258 +/- 274.1 days. Most (86%) metastases were hepatic (n = 19). During the follow-up period, the remaining 26 patients (54%) never developed metastases. Patients with metastatic disease (n = 22) had significantly lower mean ADCs than did those without metastases (1.27 x 10(-3) vs 1.43 x 10(-3) mm(2)/s; p = 0.047). The ADC of PDAC had a positive correlation with survival: patients with PDAC with lower ADCs (< 1.36 x 10(-3) mm(2)/s) had significantly worse 4-year OS rates than did patients with higher ADC values (p = 0.036). |
3 |
| 81. Okada KI, Kawai M, Hirono S, et al. Diffusion-weighted MRI predicts the histologic response for neoadjuvant therapy in patients with pancreatic cancer: a prospective study (DIFFERENT trial). Langenbecks Arch Surg. 405(1):23-33, 2020 Feb. |
Observational-Dx |
28 patients |
To elucidate correlation between pre-/post-treatment whole-tumor apparent diffusion coefficient (ADC) value and rate of tumor cell destruction. |
Pre-/post-treatment whole-tumor ADC value correlated with tumor cell destruction rate by all parameters (R = 0.630/0.714, P < 0.001/< 0.0001). The post-treatment cutoff value of ADC at the site of vascular contact for discriminating histological response of tumor destruction of </= 50% and tumor destruction of > 50% was determined at 1.42 x 10(-3) mm(2)/s. It predicts R0 with 88% sensitivity, 50% specificity, and 61% accuracy. For histological response, the post-treatment whole-tumor ADC cutoff value for discriminating between tumor destruction of </= 50% and tumor destruction of > 50% was determined at 1.40 x 10(-3) mm(2)/s. It predicts histological response with 100% sensitivity, 81% specificity, and 89% accuracy. It predicts R0 with 88% sensitivity, 70% specificity, and 75% accuracy. |
3 |
| 82. Yang S, Liu J, Jin H, He X, Nie P, Wang C. Value of magnetic resonance images in preoperative staging and resectability assessment of pancreatic cancer. J Cancer Res Ther. 14(1):155-158, 2018 Jan. |
Observational-Dx |
31 cases |
To evaluate the clinical value of magnetic resonance images (MRI) in preoperative staging and resectability evaluation of pancreatic cancer. |
According to pathological staging, there were 12 cases of Stage I, 13 cases of Stage II, 4 cases of Stage III, and 2 case of Stage IV. However, for preoperative MRI stage, there were 13 cases of Stage I, 14 cases of Stage II, 4 cases of Stage III. In addition, there was no significant difference in the distribution frequency of pathological staging and MRI staging (P > 0.05). This finding indicated that the results of MRI staging were consistent with that of postoperative pathological staging. The pathology I/II or III/IV stage of pancreatic cancer patients could be predicted with preoperative abdominal MRI detection, with the sensitivity of 1.00 and the specificity of 0.67. |
3 |
| 83. Lee S, Kim SH, Park HK, Jang KT, Hwang JA, Kim S. Pancreatic Ductal Adenocarcinoma: Rim Enhancement at MR Imaging Predicts Prognosis after Curative Resection. Radiology. 288(2):456-466, 2018 08. |
Observational-Dx |
143 patients |
To identify features at preoperative magnetic resonance (MR) imaging that could predict favorable prognosis after curative resection of pancreatic ductal adenocarcinoma (PDAC). |
Tumor size at histopathologic analysis was associated with both DFS and OS (hazard ratio per centimeter, 1.37; 95% confidence interval: 1.15, 1.63; P < .001 and hazard ratio, 1.44; 95% confidence interval: 1.20, 1.73; P < .001, respectively). Rim enhancement at dynamic contrast material-enhanced MR imaging was associated with significantly worse DFS and OS (hazard ratio, 1.72; 95% confidence interval: 1.05, 2.82; P = .030 and hazard ratio, 2.27; 95% confidence interval: 1.39, 3.69; P = .001, respectively). Diffusion-weighted imaging parameters, including diffusion restriction and apparent diffusion coefficient value, did not predict DFS or OS after resection of PDAC (all P > .05). Rim-enhancing lesions had more aggressive histologic tumor grades, less frequent remaining acini, and more frequent necrosis within the tumor compared with non-rim-enhancing pancreatic lesions (P = .002, P = .008, and P < .001, respectively). |
3 |
| 84. Jia H, Li J, Huang W, Lin G. Multimodel magnetic resonance imaging of mass-forming autoimmune pancreatitis: differential diagnosis with pancreatic ductal adenocarcinoma. BMC med. imaging. 21(1):149, 2021 10 15. |
Observational-Dx |
12 patients with mass-forming AIP and 30 with PDAC |
To assess the value of the multimodel magnetic resonance imaging (MRI), including unenhanced images, dynamic contrast-enhanced MRI (DCE-MRI), MR-cholangiopancreatography (MRCP), and diffusion-weighted imaging (DWI), in differentiation of mass-forming autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC). |
Several statistically significant MR findings and quantitative indexes differentiating mass-forming AIP from PDAC, including multiplicity, irregularity or conformation, capsule-like rim enhancement, absence of internal cystic or necrotic portion, homogeneous enhancement during pancreatic, venous, and delayed phases, skipped stricture or stricture of MPD, absence of side branch dilation, maximum upstream MPD diameter < 2.4 mm, Contrast(UP) > 0.739, Contrast(AP) > 0.710, Contrast(PP) > 0.879, and Contrast(VP) or Contrast(DP) > 0.949, indicated mass-forming AIP (P < 0.05). The apparent diffusion coefficient (ADC) value was also significantly lower in mass-forming AIP compared to that in PDAC (P = 0.006). The cutoff value of ADC for distinguishing mass-forming AIP from PDAC was 1.099 x 10(-3) mm(2)/s. |
3 |
| 85. Lu S, Liang J, Liao S, Wu D, Wu F, Li H. Use of MRI signal intensity ratio to differentiate between autoimmune pancreatitis and pancreatic ductal adenocarcinoma. Clin Radiol. 77(1):e84-e91, 2022 01. |
Observational-Dx |
21 patients with AIP and 27 patients with PDA |
To evaluate the accuracy of the lesion-to-erector spinae signal intensity ratio (SIR) on magnetic resonance imaging (MRI) for distinguishing autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDA). |
The mean SIRs of the pancreatic lesions and erector spinae from T2WI, AP, and DP images of AIP patients were 0.96, 1.27, and 1.42, respectively, while those of PDA patients were 1.35, 0.80, and 0.91, respectively. The differences in the SIRs between the AIP and PDA groups were statistically significant (p<0.001), with corresponding area under curve (AUC) values of 0.925, 0.906, and 0.961, respectively. The optimal cut-off values for the SIRs on T2WI, AP and DP images were 1.21, 1.01, and 1.08, respectively. SIR values < 1.21 on T2WI, >1.01 on AP imaging, and >1.08 on DP imaging identified AIP with sensitivities of 85.7%, 90.5%, and 90.5%, respectively, and specificities of 81.5%, 74.6%, and 81.5%, respectively. The AUC values for SIRs did not differ significantly between T2WI and DP imaging or AP and DP imaging (Z = 0.778, p=0.436; Z = 1.279, p=0.201). |
3 |
| 86. Yoon SB, Jeon TY, Moon SH, Lee SM, Kim MH. Systematic review and meta-analysis of MRI features for differentiating autoimmune pancreatitis from pancreatic adenocarcinoma. Eur Radiol. 32(10):6691-6701, 2022 Oct. |
Meta-analysis |
12 studies |
To identify reliable MRI features for differentiating autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC) and to summarize their diagnostic accuracy. |
Twelve studies were included, and 92 overlapping descriptors were subsumed under 16 MRI features. Ten features favoring AIP were diffuse enlargement (DOR, 75; 95% CI, 9-594), capsule-like rim (DOR, 52; 95% CI, 20-131), multiple main pancreatic duct (MPD) strictures (DOR, 47; 95% CI, 17-129), homogeneous delayed enhancement (DOR, 46; 95% CI, 21-104), low apparent diffusion coefficient value (DOR, 30), speckled enhancement (DOR, 30), multiple pancreatic masses (DOR, 29), tapered narrowing of MPD (DOR, 15), penetrating duct sign (DOR, 14), and delayed enhancement (DOR, 13). Six features favoring PDAC were target type enhancement (DOR, 41; 95% CI, 11-158), discrete pancreatic mass (DOR, 35; 95% CI, 15-80), upstream MPD dilatation (DOR, 13), peripancreatic fat infiltration (DOR, 10), upstream parenchymal atrophy (DOR, 5), and vascular involvement (DOR, 3). |
Good |
| 87. Ha J, Choi SH, Kim KW, Kim JH, Kim HJ. MRI features for differentiation of autoimmune pancreatitis from pancreatic ductal adenocarcinoma: A systematic review and meta-analysis. [Review]. Dig Liver Dis. 54(7):849-856, 2022 07. |
Meta-analysis |
9 studies |
To determine significant MRI features for differentiating AIP from PDAC, including assessment of diffusion-weighted imaging (DWI). |
Of nine studies (775 patients), multiple main pancreatic duct (MPD) strictures, absence of upstream marked MPD dilatation, peripancreatic rim, and duct penetration sign were significant MRI features for differentiating AIP from PDAC. Absence of MPD dilatation had the highest pooled sensitivity (87%, 95% CI=68-96%), whereas peripancreatic rim had the highest pooled specificity (100%, 95% CI=88-100%). Of 12 studies evaluating DWI, seven reported statistically significant differences in apparent diffusion coefficient (ADC) values between AIP and PDAC; however, four reported lower ADC values in AIP than in PDAC, but three reported the opposite result. |
Good |
| 88. Leeuw D, Pranger BK, de Jong KP, Pennings JP, de Meijer VE, Erdmann JI. Routine Chest Computed Tomography for Staging of Pancreatic Head Carcinoma. Pancreas. 49(3):387-392, 2020 03. |
Observational-Dx |
848 patients |
To determine if routine chest CT revealed significant lesions that altered the management of patients with suspected pancreatic head carcinoma. |
In 7 of 18 Dutch pancreatic cancer centers (39%), a preoperative chest CT is not routinely performed. In the study cohort, 170 of 848 patients (20%) were referred without chest CT and underwent one by local protocol. Chest CT revealed new suspicious lesions in 17 patients (10%), of whom 6 had metastatic disease (3.5%). |
3 |
| 89. Suker M, Groot Koerkamp B, Nuyttens JJ, et al. The yield of chest computed tomography in patients with locally advanced pancreatic cancer. J Surg Oncol. 122(3):450-456, 2020 Sep. |
Observational-Dx |
124 patients |
To evaluate the incidence of pulmonary metastases on chest computed tomography (CT) in patients with locally advanced pancreatic cancer (LAPC). |
In 124 consecutive patients diagnosed with LAPC, 119 (96%) patients underwent a staging chest CT scan at the initial presentation. In 88 (74%) patients no pulmonary nodules were found; in 16 (13%) patients an apparent benign pulmonary nodule was found, and in 15 (13%) patients a pulmonary nodule too small to characterize was found. Follow-up chest CT scan(s) were performed in 111 (93%) patients. In one patient with either no pulmonary nodule or an apparent benign pulmonary nodule at initial staging, an apparent malignant pulmonary nodule was found on a follow-up chest CT scan. However, a biopsy of the nodule was inconclusive. Of 15 patients in whom a pulmonary nodule too small to characterize was found at staging, 12 (80%) patients underwent a follow-up CT scan; in 4 (33%) of these patients, an apparent malignant pulmonary nodule was found. |
3 |
| 90. Zambirinis CP, Midya A, Chakraborty J, et al. Recurrence After Resection of Pancreatic Cancer: Can Radiomics Predict Patients at Greatest Risk of Liver Metastasis?. Ann Surg Oncol. 29(8):4962-4974, 2022 Aug. |
Observational-Dx |
688 resected PDAC patients |
To report a retrospective analysis of liver metastasis (LM) in a large cohort of patients with resected pancreatic ductal adenocarcinoma (PDAC), and the development of radiomics-based models to predict risk of early LM. |
In 688 resected PDAC patients, there were 516 recurrences (75%). The cumulative incidence of LM at 5 years was 41%, and patients who developed LM first (n = 194) had the lowest 1-year overall survival (OS) (34%), compared with 322 patients who developed extrahepatic recurrence first (61%). Independent predictors of time to LM included poor tumor differentiation (hazard ratio (HR) = 2.30; P < 0.001), large tumor size (HR = 1.17 per 2-cm increase; P = 0.048), lymphovascular invasion (HR = 1.50; P = 0.015), and liver Fibrosis-4 score (HR = 0.89 per 1-unit increase; P = 0.029) on multivariate analysis. A model using radiomic variables that reflect hepatic parenchymal heterogeneity identified patients at risk for early LM with an area under the receiver operating characteristic curve (AUC) of 0.71; the performance of the model was improved by incorporating preoperative clinicopathological variables (tumor size and differentiation status; AUC = 0.74, negative predictive value (NPV) = 0.86). |
3 |
| 91. Elmi A, Murphy J, Hedgire S, et al. Post-Whipple imaging in patients with pancreatic ductal adenocarcinoma: association with overall survival: a multivariate analysis. Abdom Radiol. 42(8):2101-2107, 2017 08. |
Observational-Dx |
229 patients who underwent Whipple for resection of PDAC |
To compare the survival outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) who had regular imaging surveillance with those who had clinical follow-up after Whipple. |
Patients were followed for a mean period of 24.35 ± 2.56 months. IS-group underwent significantly more imaging (4.41 vs. 2.08 scans/year). The most frequent imaging was CT of chest and abdomen at 3-4 month interval. Univariate associations with overall survival were detected with post-Whipple ECOG status, T-stage, N-stage, tumor grade, surgical margin, recurrence, and IS. In multivariate analysis, grade, ECOG status, and recurrence were independent predictors of survival. Also, our predictor of interest, IS, was highly associated with longer survival in multivariate modeling (median overall survival, 30.4±3.85 (IS-group) vs. 17.1 ± 2.42 (C-groups) month, log-rank p = 0.002). |
4 |
| 92. Noie T, Harihara Y, Akahane M, et al. Portal encasement: Significant CT findings to diagnose local recurrence after pancreaticoduodenectomy for pancreatic cancer. Pancreatology. 18(8):1005-1011, 2018 Dec. |
Observational-Dx |
61 patients |
To demonstrate the utility of portal encasement as a criterion for early diagnosis of local recurrence (LR) after pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC). |
Benign portal stenosis was found on the first postoperative CT imaging in 16 patients. However, stenosis resolved a median of 81 days later in all but one patient whose stenosis was due to portal reconstruction during PD. Portal encasement could be distinguished from benign portal stenosis based on the timing of emergence of the portal stenosis. Portal encasement developed in 13 of the 19 patients with LR, including 6 patients in whom the finding of portal encasement led to the diagnosis of LR a median of 147 days earlier with our diagnostic criterion compared with the conventional diagnostic criteria. |
3 |
| 93. Chu LC, Wang ZJ, Kambadakone A, et al. Postoperative surveillance of pancreatic ductal adenocarcinoma (PDAC) recurrence: practice pattern on standardized imaging and reporting from the society of abdominal radiology disease focus panel on PDAC. Abdom Radiol (NY) 2023;48:318-39. |
Review/Other-Dx |
N/A |
to assess the practice patterns across major academic institutions and develop consensus recommendations for postoperative imaging and interpretation in patients with PDAC. |
Significant variations currently exist in the postoperative surveillance of PDAC, even among academic institutions. Differentiating common postoperative inflammatory and fibrotic changes from tumor recurrence remains a diagnostic challenge, and there is no reliable size threshold or growth rate of imaging findings that can provide differentiation. A new liver lesion or peritoneal nodule should be considered suspicious for tumor recurrence, and the imaging features should be interpreted in the appropriate clinical context (e.g., CA 19-9, clinical presentation, pathologic staging). |
4 |
| 94. De Robertis R, Geraci L, Tomaiuolo L, et al. Liver metastases in pancreatic ductal adenocarcinoma: a predictive model based on CT texture analysis. Radiol Med (Torino). 127(10):1079-1084, 2022 Oct. |
Observational-Dx |
220 patients |
To develop a predictive model for liver metastases in patients with pancreatic ductal adenocarcinoma (PDAC) based on textural features of the primary tumor extracted by computed tomography (CT) images. |
This study included 220 patients. Eight variables (tumor size, arterial HU_MAX, arterial GLRLM_LRLGE, arterial GLZLM_SZHGE, arterial GLZLM_LZLGE, portal GLCM_CORRELATION, portal GLRLM_LRLGE, and portal GLZLM_SZHGE) were significantly different between groups. The logistic regression model was statistically significant (chi(2) = 81.6, p < .001) and correctly classified 80.9% of cases. Sensitivity, specificity, positive and negative predictive values of the model were 58.6%, 91.3%, 75.9% and 82.5%, respectively. The area under the ROC curve of the model was 0.850 (95% CI, 0.793-0.907). Tumor size, arterial HU_MAX, arterial GLZLM_SZHGE and portal GLCM_CORRELATION were significant predictors of the likelihood of liver metastases, with odds ratios of 1.1, 0.9, 1, and 1.49, respectively. |
3 |
| 95. Albano D, Familiari D, Gentile R, et al. Clinical and prognostic value of 18F-FDG-PET/CT in restaging of pancreatic cancer. Nucl Med Commun. 39(8):741-746, 2018 Aug. |
Observational-Dx |
52 patients |
To evaluate the clinical and prognostic effect of fluorine-18-fluorodeoxyglucose (F-FDG)-PET/computed tomography (CT) in the restaging process of pancreatic cancer (PC). |
Fifty-two patients (33 males and 19 females, with mean age of 59 years and range: 42-78 years) with PC were finally included in our study. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of F-FDG-PET were 85, 84, 90, 76, and 84%, respectively. Area under the curve was 0.84 (95% confidence intervals: 0.72-0.96; P<0.05). LR+ and LR- were 5.3 and 0.17, respectively. F-FDG-PET/CT revealed new metastatic foci in 5/52 patients (10%) and excluded suspicious lesions in 11/52 (21%). Analysis of PFS revealed F-FDG-PET/CT positivity to be associated with a worse cumulative survival rate over a 6 and 12-month period in comparison with F-FDG-PET/CT negativity (6-month PFS 95 vs. 67%, P<0.05; 12-month PFS 81 vs. 29%, P<0.05). A negative F-FDG-PET/CT result was associated with a significantly longer overall survival than a positive one (70 vs. 26% after 2 years, P<0.05). In addition, a positive F-FDG-PET/CT scan result and an maximum standardized uptake value (SUVmax) value more than 6 were significantly associated with an increased risk of disease progression (PET positivity hazard ratio=3.9, P=0.01; SUVmax>6 h=4.2, P=0.02) and death (PET positivity hazard ratio=3.5, P=0.02; SUVmax>6 h=3.7, P=0.01). |
4 |
| 96. Duan H, Baratto L, Iagaru A. The Role of PET/CT in the Imaging of Pancreatic Neoplasms. [Review]. Semin Ultrasound CT MR. 40(6):500-508, 2019 Dec. |
Review/Other-Dx |
N/A |
To aim to overview molecular pancreatic imaging. |
No results stated in abstract. |
4 |
| 97. National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Committee on National Statistics; Committee on Measuring Sex, Gender Identity, and Sexual Orientation. Measuring Sex, Gender Identity, and Sexual Orientation. In: Becker T, Chin M, Bates N, eds. Measuring Sex, Gender Identity, and Sexual Orientation. Washington (DC): National Academies Press (US) Copyright 2022 by the National Academy of Sciences. All rights reserved.; 2022. |
Review/Other-Dx |
N/A |
Sex and gender are often conflated under the assumptions that they are mutually determined and do not differ from each other; however, the growing visibility of transgender and intersex populations, as well as efforts to improve the measurement of sex and gender across many scientific fields, has demonstrated the need to reconsider how sex, gender, and the relationship between them are conceptualized. |
No abstract available. |
4 |
| 98. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/Clinical/Appropriateness-Criteria/ACR-Appropriateness-Criteria-Radiation-Dose-Assessment-Introduction.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
