The Role of MR Imaging in Pancreatic Cancer

Jha, Priyanka; Yeh, Benjamin M.; Zagoria, Ronald J.; Collisson, Eric A.; Wang, Zhen J.

doi:10.1016/j.mric.2018.03.004

Cited by 16 publications

(8 citation statements)

References 55 publications

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“…Despite its high sensitivity, CT‐based contrasts do not manage to detect PDAC with full reliability 4 ; also, other highly diagnostic methods like FDG‐PET, have not been established to date as reliable tools for PDAC detection 5 . 1 H‐based MRI methods should excel in characterizing soft glands such as the pancreas, yet tumors show little contrast in it when weighted by their natural T 1 , T 2 relaxation times, or even when relying on Gd‐based contrast agents, which show limited extravasation 6–8 . The main MR‐based procedure for the diagnosis of PDAC remains magnetic resonance cholangiopancreatography 7 ; also, diffusivity has led to promising data that can be used to highlight tumors in vivo 8–12 .…”

Section: Introductionmentioning

confidence: 99%

“…1 H‐based MRI methods should excel in characterizing soft glands such as the pancreas, yet tumors show little contrast in it when weighted by their natural T 1 , T 2 relaxation times, or even when relying on Gd‐based contrast agents, which show limited extravasation 6–8 . The main MR‐based procedure for the diagnosis of PDAC remains magnetic resonance cholangiopancreatography 7 ; also, diffusivity has led to promising data that can be used to highlight tumors in vivo 8–12 . Overall, imaging contrast for this kind of tumor is hard to achieve, and when available it is hard to discern from cysts and inflammations.…”

Section: Introductionmentioning

confidence: 99%

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Deuterium MRSI characterizations of glucose metabolism in orthotopic pancreatic cancer mouse models

et al. 2021

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Detecting and mapping metabolism in tissues represents a major step in detecting, characterizing, treating and understanding cancers. Recently introduced deuterium metabolic imaging techniques could offer a noninvasive route for the metabolic imaging of animals and humans, based on using 2H magnetic resonance spectroscopic imaging (MRSI) to detect the uptake of deuterated glucose and the fate of its metabolic products. In this study, 2H6,6′‐glucose was administered to mice cohorts that had been orthotopically implanted with two different models of pancreatic ductal adenocarcinoma (PDAC), involving PAN‐02 and KPC cell lines. As the tumors grew, 2H6,6′‐glucose was administered as bolii into the animals' tail veins, and 2H MRSI images were recorded at 15.2 T. 2D phase‐encoded chemical shift imaging experiments could detect a signal from this deuterated glucose immediately after the bolus injection for both the PDAC models, reaching a maximum in the animals' tumors ~ 20 min following administration, and nearly total decay after ~ 40 min. The main metabolic reporter of the cancers was the 2H3,3′‐lactate signal, which MRSI could detect and localize on the tumors when these were 5 mm or more in diameter. Lactate production time traces varied slightly with the animal and tumor model, but in general lactate peaked at times of 60 min or longer following injection, reaching concentrations that were ~ 10‐fold lower than those of the initial glucose injection. This 2H3,3′‐lactate signal was only visible inside the tumors. 2H‐water could also be detected as deuterated glucose's metabolic product, increasing throughout the entire time course of the experiment from its ≈10 mM natural abundance background. This water resonance could be imaged throughout the entire abdomen of the animals, including an enhanced presence in the tumor, but also in other organs like the kidney and bladder. These results suggest that deuterium MRSI may serve as a robust, minimally invasive tool for the monitoring of metabolic activity in pancreatic tumors, capable of undergoing clinical translation and supporting decisions concerning treatment strategies. Comparisons with in vivo metabolic MRI experiments that have been carried out in other animal models are presented and their differences/similarities are discussed.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Deuterium MRSI characterizations of glucose metabolism in orthotopic pancreatic cancer mouse models

et al. 2021

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“…One of these limitations comes from the fact that PDACs are often underirrigated, and hence will not show hyperintensity upon injection of Gd-based contrast agents. 9,10 Standard clinical MR protocols for PDAC analyses also include T 1 -and T 2 -weighted imaging 11 : both T 1 and T 2 relaxation times for healthy human pancreas are known, and thus their changes could be potentially useful pathology indicators. 12 PDAC masses usually appear hypointense in fat-suppressed T 1 -weighted images compared with healthy tissue, reflecting longer T 1 times associated with the fibrotic nature of the tumor.…”

Section: Introductionmentioning

confidence: 99%

“…5,14 The main MR-based procedure clinically recommended for the (relatively late-stage) diagnosis of PDAC remains magnetic resonance cholangio pancreatography (MRCP), a long-echo-time sequence that leaves solely the biliary ducts in the image, and can therefore point towards the presence of tumors if they distort the ducts' normal shapes. 15 A case has also been made for the inclusion of diffusion-weighted imaging (DWI) in these diagnoses 10,16 ; apparently, due to the fibrotic nature of the stroma and the tumor's high cellularity, 17 these will have lower diffusivity and appear bright in DWI data. 16,18,19 This, however, has also been described as not always being the case for a large study of human subjects.…”

Section: Introductionmentioning

confidence: 99%

“…Cross‐sectional CT‐based imaging methods are not accurate enough for the early detection of pancreatic cancer, and 1 H MRI, which has unparalleled abilities to “see” soft tissues in detail, has proven remarkably ineffective when it comes to screening PDAC. One of these limitations comes from the fact that PDACs are often underirrigated, and hence will not show hyperintensity upon injection of Gd‐based contrast agents 9,10 . Standard clinical MR protocols for PDAC analyses also include T 1 ‐ and T 2 ‐weighted imaging 11 : both T 1 and T 2 relaxation times for healthy human pancreas are known, and thus their changes could be potentially useful pathology indicators 12 .…”

Section: Introductionmentioning

confidence: 99%

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Identification of variable stages in murine pancreatic tumors by a multiparametric approach employing hyperpolarized ¹³C MRSI, ¹H diffusivity and ¹H T₁ MRI

et al. 2020

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This study explored the usefulness of multiple quantitative MRI approaches to detect pancreatic ductal adenocarcinomas in two murine models, PAN-02 and KPC. Methods assayed included 1 H T 1 and T 2 measurements, quantitative diffusivity mapping, magnetization transfer (MT) 1 H MRI throughout the abdomen and hyperpolarized 13 C spectroscopic imaging. The progress of the disease was followed as a function of its development; studies were also conducted for wildtype control mice and for mice with induced mild acute pancreatitis. Customized methods developed for scanning the motion-and artifact-prone mice abdomens allowed us to obtain quality 1 H images for these targeted regions. Contrasts between tumors and surrounding tissues, however, were significantly different. Anatomical images, T 2 maps and MT did not yield significant contrast unless tumors were large. By contrast, tumors showed statistically lower diffusivities than their surroundings (≈8.3 ± 0.4 x 10 −4 for PAN-02 and ≈10.2 ± 0.6 x 10 −4 for KPC vs 13 ± 1 x 10 −3 mm 2 s −1 for surroundings), longer T 1 relaxation times (≈1.44 ± 0.05 for PAN-02 and ≈1.45 ± 0.05 for KPC vs 0.95 ± 0.10 seconds for surroundings) and significantly higher lactate/ pyruvate ratios by hyperpolarized 13 C MR (0.53 ± 0.2 for PAN-02 and 0.78 ± 0.2 for KPC vs 0.11 ± 0.04 for control and 0.31 ± 0.04 for pancreatitis-bearing mice). Although the latter could also distinguish early-stage tumors from healthy animal controls, their response was similar to that in our pancreatitis model. Still, this ambiguity could be lifted using the 1 H-based reporters. If confirmed for other kinds of pancreatic tumors this means that these approaches, combined, can provide a route to an early detection of pancreatic cancer.

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Radiologic Diagnosis of Pancreatic Cancer

Recht

Fishman

2023

The Pancreas

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The Role of MR Imaging in Pancreatic Cancer

Cited by 16 publications

References 55 publications

Deuterium MRSI characterizations of glucose metabolism in orthotopic pancreatic cancer mouse models

Deuterium MRSI characterizations of glucose metabolism in orthotopic pancreatic cancer mouse models

Identification of variable stages in murine pancreatic tumors by a multiparametric approach employing hyperpolarized ¹³C MRSI, ¹H diffusivity and ¹H T₁ MRI

Radiologic Diagnosis of Pancreatic Cancer

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The Role of MR Imaging in Pancreatic Cancer

Cited by 16 publications

References 55 publications

Deuterium MRSI characterizations of glucose metabolism in orthotopic pancreatic cancer mouse models

Deuterium MRSI characterizations of glucose metabolism in orthotopic pancreatic cancer mouse models

Identification of variable stages in murine pancreatic tumors by a multiparametric approach employing hyperpolarized 13C MRSI, 1H diffusivity and 1H T1 MRI

Radiologic Diagnosis of Pancreatic Cancer

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Identification of variable stages in murine pancreatic tumors by a multiparametric approach employing hyperpolarized ¹³C MRSI, ¹H diffusivity and ¹H T₁ MRI