Prognostic Imaging Biomarkers for Pancreatic Ductal Adenocarcinoma Extracted from Structured Radiologist Reports

Abstract

HomeRadiology: Imaging CancerVol. 2, No. 6 PreviousNext Research HighlightsFree AccessPrognostic Imaging Biomarkers for Pancreatic Ductal Adenocarcinoma Extracted from Structured Radiologist ReportsNikita ConsulNikita ConsulNikita ConsulPublished Online:Nov 27 2020https://doi.org/10.1148/rycan.2020209032MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked InEmail Take-Away Points■ Major Focus: Use of a structured reporting template for pancreatic ductal adenocarcinoma to extract potential prognostic and predictive imaging biomarkers.■ Key Result: Tumor-arterial contact, portal vein deformity, larger tumor size, and presence of venous collaterals were found to be associated with decreased overall survival in patients with pancreatic ductal adenocarcinoma.■ Impact: Routine use of the structured reporting template could allow for increased imaging data extraction and preoperative stratification of patients with pancreatic ductal adenocarcinoma based on imaging biomarkers.In this era of precision medicine, biomarkers are instrumental to prognosticate and predict survival in our patients with cancer. Such biomarkers could be advantageous in preoperative cases of pancreatic ductal adenocarcinoma, an aggressive epithelial cell malignancy associated with extremely poor prognosis. While CA-A-19 is a widely recognized serum marker for pancreatic ductal adenocarcinoma, levels of this protein do not have prognostic value alone (1). However, preoperative CT in conjunction with CA-A-19 levels and the physician’s subjective assessment have exhibited predictive value for 2-year survival (2). Consequently, many studies have evaluated the role for imaging in measuring preoperative tumor extent and posttherapy treatment response, recognizing that imaging biomarkers could be used for noninvasive prognostication.In a retrospective study of patients with pancreatic ductal adenocarcinoma who underwent preoperative CT imaging and curative intent surgical resection between 2006 and 2017, Dickinson et al describe multiple imaging features that were associated with decreased overall survival in patients who underwent surgery either with or without neoadjuvant therapy, including tumor contact with the common hepatic artery or other arteries, portal vein deformity, larger tumor size, and the presence of venous collaterals. These features were extracted from the structured American Pancreatic Association (APA)/Society of Abdominal Radiology (SAR) reporting template (3), and therefore the authors conclude that the use of this template may identify imaging features that predict survival. Furthermore, widespread use of the APA/SAR reporting template will equip future studies of imaging biomarkers for the preoperative stratification of patients with pancreatic ductal adenocarcinoma.Highlighted ArticleDickinson SM, McIntyre CA, Schilsky JB, et al. Preoperative CT predictors of survival in patients with pancreatic ductal adenocarcinoma undergoing curative intent surgery. Abdom Radiol 2020. doi: https://doi.org/10.1007/s00261-020-02726-w