Impact of PET/MRI in the Treatment of Pancreatic Adenocarcinoma: a Retrospective Cohort Study

Mol Imaging Biol. 2021 Jun;23(3):456-466. doi: 10.1007/s11307-020-01569-7. Epub 2021 Jan 7.

Abstract

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.

Keywords: FDG; MRI; Management changes; PET; PET/MRI; Pancreatic cancer.

MeSH terms

  • Adenocarcinoma / diagnostic imaging*
  • Adenocarcinoma / therapy*
  • Aged
  • Female
  • Fluorodeoxyglucose F18 / pharmacology
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / therapy*
  • Positron Emission Tomography Computed Tomography / methods
  • Positron-Emission Tomography / methods*
  • Retrospective Studies
  • Tomography, X-Ray Computed

Substances

  • Fluorodeoxyglucose F18