Keywords:
Oncology, Pancreas, Abdomen, CT, Image manipulation / Reconstruction, Outcomes analysis, Cancer
Authors:
E. Raimondi1, K. Young2, K. Kouvelakis2, D.-M. Koh2, V. Calamai2, N. Starling2, M. A. Bali2; 1Ferrara/IT, 2London/UK
DOI:
10.1594/ecr2018/C-2169
Aims and objectives
Pancreatic adenocarcinoma (PDA) is the fourth cause of cancer-related death,
having a five-years survival rate of 8% [1].
The therapeutic approach to advanced unresectable PDA is systemic cytotoxic chemotherapy.
FOLFIRINOX regimen is currently used as first-line systemic treatment in advanced PDA,
showing a significant improvement in terms of survival compared to gemcitabine in metastatic pancreatic cancer (MPC),
whereas similar results have not yet been proven in locally advanced pancreatic cancer (LAPC) [2].
Contrast-enhanced CT (CECT) is the conventional imaging modality for response assessment in this setting.
The radiological evaluation of therapy efficacy relies on RECIST 1.1 criteria,
which consider changes in tumour size to identify treatment-induced changes [3].
PDA is histologically characterized by large amount of cancerous stromal tissue,
which means that cytotoxic therapy can determine intra-lesional scarring and necrosis with no apparent change in tumour size [4].
Therefore,
response assessment based on size alone could lack the whole spectrum of morphological treatment-induced changes of PDA.
New radiological biomarkers such as CT-texture analysis (CTTA) metrics have shown to relate with favorable response to treatment in other abdominal malignancies such as liver metastases from colorectal cancer and renal cell carcinoma [5-6].
Other studies have already explored the potential added value of CTTA in PDA to assess response to treatment [7].
The purpose of the present study was to assess in patients with advanced PDA treated with FOLFIRINOX chemotherapy regimen changes in CTTA metrics calculated respectively in responders and non-responders according to RECIST1.1 categorization.