The Role of 18F-FDG PET/CT and PET/MRI in Pancreatic Ductal Adenocarcinoma
The Role of 18F-FDG PET/CT and PET/MRI in Pancreatic Ductal Adenocarcinoma
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DOI：
10.1007/s00261-017-1374-2
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发表时间：
2018-02-01
影响因子：
2.4
通讯作者：
Goenka, Ajit H.
中科院分区：
文献类型：
--
作者：
Yeh, Randy;Dercle, Laurent;Goenka, Ajit H.
胰腺导管腺癌（PDAC）仍然是一种难以治疗的疾病，并且仍然预示着预后不良，因为大多数患者在诊断时无法切除。18f -氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）联合CT （PET/CT）已成为不同癌症肿瘤成像的基石；然而，PET/CT在PDAC中的作用正在不断发展，目前尚未得到很好的确立。研究表明PET/CT在指导PDAC患者管理方面的潜力，在某些情况下可能比CT或MRI解剖成像更有优势。PET/CT可用于诊断、初始分期、治疗反应评估、复发肿瘤与治疗后纤维化的区分以及放疗计划。此外，PET/CT可能是一种具有成本效益的方式，因为最初被认为是手术候选人的患者。最近，同时PET/MRI的出现代表了混合功能成像的一个令人兴奋的进步，在PDAC成像中具有潜在的应用前景。PET/MRI的优点包括同时采集以改善融合图像的配准，较低的辐射剂量，优越的软组织对比度，以及多参数成像的可用性。研究正在评估PET/MRI在PDAC中的效用，包括初始分期和治疗反应评估，并确定将受益于PET/MRI的患者亚组。PET/CR和PET/MRI的进一步研究是必要的，以更好地了解这些模式在PDAC中的作用。
Pancreatic ductal adenocarcinoma (PDAC) remains a difficult disease to treat and continues to portend a poor prognosis, as most patients are unresectable at diagnosis. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) combined with CT (PET/CT) has been a cornerstone in oncological imaging of different cancers; however, the role of PET/CT in PDAC is continually evolving and currently not well established. Studies have shown the potential of PET/CT in guiding the management of patients with PDAC, with possible added benefit over anatomic imaging with CT or MRI in certain scenarios. PET/CT may be useful in diagnosis, initial staging, treatment response assessment, differentiation of recurrent tumor from post-treatment fibrosis, and radiotherapy planning. Additionally, PET/CT may be a cost-effective modality due to upstaging of patients originally deemed as surgical candidates. Recently, the advent of simultaneous PET/MRI represents an exciting advancement in hybrid functional imaging with potential applications in the imaging of PDAC. The advantages of PET/MRI include simultaneous acquisition to improve registration of fusion images, lower radiation dose, superior soft tissue contrast, and availability of multiparametric imaging. Studies are underway to evaluate the utility of PET/MRI in PDAC, including in initial staging and treatment response assessment and to determine the subgroup of patients that will benefit from PET/MRI. Further studies are warranted in both PET/CR and PET/MRI to better understand the role of these modalities in PDAC.