González-Gómez Ruth, Pazo-Cid Roberto A, Sarría Luis, Morcillo Miguel Ángel, Schuhmacher Alberto J
Molecular Oncology Group, Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain.
Medical Oncology Unit, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain.
J Clin Med. 2021 Mar 10;10(6):1151. doi: 10.3390/jcm10061151.
Diagnosis of pancreatic ductal adenocarcinoma (PDAC) by current imaging techniques is useful and widely used in the clinic but presents several limitations and challenges, especially in small lesions that frequently cause radiological tumors infra-staging, false-positive diagnosis of metastatic tumor recurrence, and common occult micro-metastatic disease. The revolution in cancer multi-"omics" and bioinformatics has uncovered clinically relevant alterations in PDAC that still need to be integrated into patients' clinical management, urging the development of non-invasive imaging techniques against principal biomarkers to assess and incorporate this information into the clinical practice. "Immuno-PET" merges the high target selectivity and specificity of antibodies and engineered fragments toward a given tumor cell surface marker with the high spatial resolution, sensitivity, and quantitative capabilities of positron emission tomography (PET) imaging techniques. In this review, we detail and provide examples of the clinical limitations of current imaging techniques for diagnosing PDAC. Furthermore, we define the different components of immuno-PET and summarize the existing applications of this technique in PDAC. The development of novel immuno-PET methods will make it possible to conduct the non-invasive diagnosis and monitoring of patients over time using in vivo, integrated, quantifiable, 3D, whole body immunohistochemistry working like a "virtual biopsy".
目前的成像技术用于诊断胰腺导管腺癌（PDAC）在临床上很有用且应用广泛，但存在一些局限性和挑战，尤其是在小病变中，这些病变经常导致放射学肿瘤分期过低、转移性肿瘤复发的假阳性诊断以及常见的隐匿性微转移疾病。癌症多“组学”和生物信息学的革命揭示了PDAC中与临床相关的改变，这些改变仍需整合到患者的临床管理中，这促使人们开发针对主要生物标志物的非侵入性成像技术，以便将这些信息评估并纳入临床实践。“免疫PET”将抗体和工程片段对特定肿瘤细胞表面标志物的高靶向选择性和特异性与正电子发射断层扫描（PET）成像技术的高空间分辨率、灵敏度和定量能力相结合。在本综述中，我们详细介绍并举例说明了当前用于诊断PDAC的成像技术的临床局限性。此外，我们定义了免疫PET的不同组成部分，并总结了该技术在PDAC中的现有应用。新型免疫PET方法的开发将使通过像“虚拟活检”一样的体内、整合、可量化、三维全身免疫组织化学对患者进行非侵入性诊断和长期监测成为可能。
