The role of FDG PET/CT or PET/MRI in assessing response to neoadjuvant therapy for patients with borderline or resectable pancreatic cancer: a systematic literature review

Abstract

The aim of the present systematic review is to examine the role of fluorodeoxyglucose (FDG) positron emission tomography (PET) associated with computed tomography (CT) or magnetic resonance imaging (MRI) in assessing response to preoperative chemotherapy or chemoradiotherapy (CRT) for patients with borderline and resectable pancreatic ductal adenocarcinoma (PDAC). Three researchers ran a database query in PubMed, Web of Science and EMBASE. The total number of patients considered was 488. The most often used parameters of response to therapy were the reductions in the maximum standardized uptake value (SUVmax) or the peak standardized uptake lean mass (SULpeak). Patients whose SUVs were higher at the baseline (before CRT) were associated with a better response to therapy and a better overall survival. SUVs remaining high after neoadjuvant therapy correlated with a poor prognosis. Available data indicate that FDG PET/CT or PET/MRI can be useful for predicting and assessing response to CRT in patients with resectable or borderline PDAC.

Nanocarriers for pancreatic cancer imaging, treatments, and immunotherapies

“…Endoscopic ultrasound (EUS) is highly sensitive in detecting small tumors that are often missed by other imaging modalities, and it also provides an opportunity to collect samples (fine needle aspirates) for cytological or biomarker analysis to facilitate the most conclusive diagnosis 177 . Metabolic PET imaging, which relies on the differential uptake of 18 F-labeled fluoro-deoxy glucose (FDG) by rapidly growing tumor cells, enables whole-body imaging to detect both primary tumors and metastasis and is used alone or in combination with CT and MRI for evaluating the response to therapy in PDAC patients 178 , 179 . The principles, utility, and current status of various imaging modalities are elegantly reviewed in several recent articles 178 , 180 - 182 .…”

“…Metabolic PET imaging, which relies on the differential uptake of 18 F-labeled fluoro-deoxy glucose (FDG) by rapidly growing tumor cells, enables whole-body imaging to detect both primary tumors and metastasis and is used alone or in combination with CT and MRI for evaluating the response to therapy in PDAC patients 178 , 179 . The principles, utility, and current status of various imaging modalities are elegantly reviewed in several recent articles 178 , 180 - 182 . Imaging modalities like abdominal ultrasound utilize microbubbles as contrast agents, which have been functionalized by targeting molecules to facilitate molecular imaging.…”

Application of Magnetic Resonance Imaging in Neoadjuvant Treatment of Pancreatic Ductal Adenocarcinoma

“…Flurodeoxyglucose positron emission tomography (PET)/ MRI is currently the latest examination technology in the field of magnetic resonance. 54 There is only one report on the application of PET/MRI in the NAT of PDAC. Panda et al 55 retrospectively studied the ability of PET/MRI and CT to assess the pathological response of PDAC to NAT and predict the OS in 44 patients.…”

“…Flurodeoxyglucose positron emission tomography (PET)/MRI is currently the latest examination technology in the field of magnetic resonance 54 . There is only one report on the application of PET/MRI in the NAT of PDAC.…”

Short-Course or Total Neoadjuvant Chemotherapy in Resectable and Borderline Resectable Pancreatic Cancer - Current Status and Future Perspectives

“…Post-chemotherapy metabolic responses based on positron emission tomography (PET/CT or PET/MRI) metabolic imaging as surrogates of pathologic response is currently used in some centers to evaluate treatment response ( 32 , 45 , 46 ). Metabolic response by PET/CT or PET/MRI may be a more sensitive measure of tumor response than traditional CT or MRI and should be evaluated in future clinical trials ( 47 ). Criteria to be considered in the evaluation of treatment response during neoadjuvant therapy in pancreatic cancer are presented in Table 2 .…”