Preoperative Multiparametric Quantitative Magnetic Resonance Imaging Correlates with Prognosis and Recurrence Patterns in Pancreatic Ductal Adenocarcinoma

Abstract

Magnetic resonance imaging (MRI) has been shown to be associated with prognosis in some tumors; however, the correlation in pancreatic ductal adenocarcinoma (PDAC) remains inconclusive. In this retrospective study, we ultimately included 136 patients and analyzed quantitative MRI parameters that are associated with prognosis and recurrence patterns in PDAC using survival analysis and competing risks models; all the patients have been operated on with histopathology and immunohistochemical staining for further evaluation. In intravoxel incoherent motion diffusion-weighted imaging (DWI), we found that pure-diffusion coefficient D value was an independent risk factor for overall survival (OS) (HR: 1.696, 95% CI: 1.003–2.869, p = 0.049) and recurrence-free survival (RFS) (HR: 2.066, 95% CI: 1.252–3.409, p = 0.005). A low D value (≤1.08 × 10−3 mm2/s) was significantly associated with a higher risk of local recurrence (SHR: 5.905, 95% CI: 2.107–16.458, p = 0.001). Subgroup analysis revealed that patients with high D and f values had significantly better outcomes with adjuvant chemotherapy. Distant recurrence patients in the high-D value group who received chemotherapy may significantly improve their OS and RFS. It was found that preoperative multiparametric quantitative MRI correlates with prognosis and recurrence patterns in PDAC. Diffusion coefficient D value can be used as a noninvasive biomarker for predicting prognosis and recurrence patterns in PDAC.

Effectiveness of magnetic resonance imaging and spiral computed tomography in the staging and treatment prognosis of colorectal cancer

“…This exacerbates the degree of barrier destruction and so the proportion of extracellular space outside the blood vessels and, consequently, V e increase. This is believed to be the reason for the link between poor prognosis and high V e values[ 22 , 23 ]. In a study on dynamic contrast enhanced-MRI quantitative parameters for predicting the efficacy of concurrent chemoradiotherapy for locally advanced cancer, Liu et al [ 24 ] discovered tumor regression when V e was low, which could be used as a potential indicator to predict the treatment response of locally advanced cancer.…”

Comprehensive Assessment of Postoperative Recurrence and Survival in Patients with Cervical Cancer: Nomograms

“…This may be because the D value primarily re ects the density of tumor cells, with lower values representing higher cell density, more active proliferation and poorer differentiation [8]. Therefore a lower D value predicts a higher risk of recurrence and a poorer prognosis, as has also been demonstrated in nasopharyngeal and pancreatic cancers [30][31]. Meanwhile, Qu [31] found that D values were negatively correlated with alphasmooth muscle actin (α-SMA) and hypoxia-inducible factors (HIFs) expression in pancreatic cancer, suggesting that D values may be closely related to broblast activation, angiogenesis and microenvironmental hypoxia in tumors, thus revealing the malignancy and treatment resistance of cancers.…”