Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA.
Abdom Radiol (NY). 2018 Feb;43(2):435-444. doi: 10.1007/s00261-017-1434-7.
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.
胰腺导管腺癌 (PDAC) 是一种侵袭性的胃肠道 (GI) 恶性肿瘤，其 5 年生存率较差。手术技术的进步和新型联合化疗和放疗方案的引入，使得评估治疗反应的生物标志物成为必要。RECIST 等常规成像方法已用于临床试验中的反应评估，特别是在转移性 PDAC 患者中。然而，由于 PDAC 的复杂形态学和组织学性质，这些方法在评估局部和全身治疗反应方面的作用有限。新辅助治疗后肿瘤可切除性的确定仍然是一个挑战。本文综述了 PDAC 反应评估中的挑战和局限性，并回顾了新型形态和功能成像工具在该疾病中的应用证据。
