Therapeutic response assessment in pancreatic ductal adenocarcinoma: society of abdominal radiology review paper on the role of morphological and functional imaging techniques

Zhen J. Wang, Hina Arif-Tiwari, Atif Zaheer, Sanaz Ameli, Priya R. Bhosale, Richard K. Do, Ajit H. Goenka, Alexander R. Guimares, Guillermo P. Sangster, Erik V. Soloff, Eric P. Tamm, Marc Zins, Avinash R. Kambadakone

Research output: Contribution to journalReview articlepeer-review

Abstract

Abstract: Pancreatic ductal adenocarcinoma (PDA) is the third leading cause of cancer-related death in the United States and is projected to be the second by 2030. Systemic combination chemotherapy is considered an essential first-line treatment for the majority of patients with PDA, in both the neoadjuvant and palliative settings. In addition, a number of novel therapies are being tested in clinical trials for patients with advanced PDA. In all cases, accurate and timely assessment of treatment response is critical to guide therapy, reduce drug toxicities and cost from a failing therapy, and aid adaptive clinical trials. Conventional morphological imaging has significant limitations, especially in the context of determining primary tumor response and resectability following neoadjuvant therapies. In this article, we 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. Graphic Abstract: [Figure not available: see fulltext.]

Original languageEnglish (US)
JournalAbdominal Radiology
DOIs
StateAccepted/In press - 2020

Keywords

  • Computed tomography
  • Magnetic resonance imaging
  • Pancreatic ductal adenocarcinoma
  • Positron emission tomography
  • Response to treatment

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

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