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Response assessment in pancreatic ductal adenocarcinoma: role of imaging

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Abstract

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive gastrointestinal (GI) malignancy with poor 5-year survival rate. Advances in surgical techniques and introduction of novel combination chemotherapy and radiation therapy regimens have necessitated the need for biomarkers for assessment of treatment response. Conventional imaging methods such as RECIST have been used for response evaluation in clinical trials particularly in patients with metastatic PDAC. However, the role of these approaches for assessing response to loco-regional and systemic therapies is limited due to complex morphological and histological nature of PDAC. Determination of tumor resectability after neoadjuvant therapy remains a challenge. This review article provides an overview of the challenges and limitations of response assessment in PDAC and reviews the current evidence for the utility of novel morphological and functional imaging tools in this disease.

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  1. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA

    Vinit Baliyan, Hamed Kordbacheh, Anushri Parakh & Avinash Kambadakone

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  1. Vinit Baliyan
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Correspondence to Avinash Kambadakone.

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Vinit Baliyan, MD declares he has no conflict of interest. Hamed Kordbacheh, MD declares he has no conflict of interest. Anushri Parakh, MD declares she has no conflict of interest. Avinash Kambadakone, MD FRCR declares Consultant, Bayer.

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Baliyan, V., Kordbacheh, H., Parakh, A. et al. Response assessment in pancreatic ductal adenocarcinoma: role of imaging. Abdom Radiol 43, 435–444 (2018). https://doi.org/10.1007/s00261-017-1434-7

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