Impact of PET/MRI in the Treatment of Pancreatic Adenocarcinoma: a Retrospective Cohort Study,Molecular Imaging and Biology

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Impact of PET/MRI in the Treatment of Pancreatic Adenocarcinoma: a Retrospective Cohort Study
Molecular Imaging and Biology ( IF 3.1 ) Pub Date : 2021-01-07 , DOI: 10.1007/s11307-020-01569-7
Felipe S Furtado _{1,

2} , Cristina R Ferrone ₃ , Susanna I Lee ₁ , Mark Vangel _{1,

2,

4} , David A Rosman ₁ , Colin Weekes ₅ , Motaz Qadan ₃ , Carlos Fernandez-Del Castillo ₃ , David P Ryan ₅ , Lawrence S Blaszkowsky _{5,

6} , Theodore S Hong ₇ , Jeffrey W Clark ₅ , Robin Striar _{1,

2} , David Groshar ₈ , Lina G Cañamaque ₉ , Lale Umutlu ₁₀ , Onofrio A Catalano _{1,

2,

11}

Affiliation

Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Vernon Cancer Center, Newton-Wellesley Hospital, 2014 Washington Street, Newton, MA, 02462, USA.
Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
Department of Nuclear Medicine, Assuta Medical Centers, Tel Aviv, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Hospital Universitario Madrid Sanchinarro, Madrid, Spain.
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
Department of Radiology, University of Naples "Parthenope", Naples, Italy.

Purpose

Imaging is central to the diagnosis and management of Pancreatic Ductal Adenocarcinoma (PDAC). This study evaluated if positron emission tomography (PET)/magnetic resonance imaging (MRI) elicited treatment modifications in PDAC when compared to standard of care imaging (SCI).

Procedures

This retrospective study included consecutive patients with PDAC who underwent 2-deoxy-2-[¹⁸F]fluoro-d-glucose ([¹⁸F]F-FDG) PET/MRI and SCI from May 2017 to January 2019. SCI included abdominal computed tomography (CT), MRI, and/or PET/CT. For patients who had more than one pair of PET/MRI and SCI, each management decision was independently evaluated. Treatment strategies based on each modality were extracted from electronic medical records. Follow-up was evaluated until January 2020.

Results

Twenty-five patients underwent 37 PET/MRI’s, mean age was 65 ± 9 years and 13 (13/25, 52 %) were men. 49 % (18/37, 95 % CI 33–64 %) of the PET/MRI scans changed clinical management. Whether the SCI included a PET/CT or not did not significantly modify the probability of management change (OR = 0.9, 95 % CI 0.2–4, p = 1). One hundred percent (33/33) of the available follow-up data confirmed PET/MRI findings.

Conclusions

PET/MRI significantly changed PDAC management, consistently across the different SCI modalities it was compared to. These findings suggest a role for PET/MRI in the management of PDAC.

中文翻译：

PET/MRI 对胰腺腺癌治疗的影响：一项回顾性队列研究

目的

影像学是胰腺导管腺癌 (PDAC) 诊断和治疗的核心。本研究评估了与护理成像标准 (SCI) 相比，正电子发射断层扫描 (PET)/磁共振成像 (MRI) 是否会引起 PDAC 的治疗修改。

程序

^{这项回顾性研究包括从 2017 年 5 月到 2019 年 1 月接受 2-脱氧-2-[ 18} F]氟-d-葡萄糖 ([ ¹⁸ F]F-FDG) PET/MRI 和 SCI 的连续 PDAC 患者。SCI 包括腹部计算机断层扫描 (CT)、MRI 和/或 PET/CT。对于有超过一对 PET/MRI 和 SCI 的患者，每个管理决策都经过独立评估。从电子病历中提取基于每种方式的治疗策略。随访评估至 2020 年 1 月。

结果

25 名患者接受了 37 次 PET/MRI，平均年龄为 65 ± 9 岁，其中 13 名 (13/25, 52 %) 为男性。49 % (18/37, 95 % CI 33–64 %) 的 PET/MRI 扫描改变了临床管理。SCI 是否包括 PET/CT 并未显着改变管理变更的概率（OR = 0.9, 95 % CI 0.2–4, p = 1）。100% (33/33) 的可用随访数据证实了 PET/MRI 的发现。