Physiologic Pancreatic Cancer Imaging Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging (Dce-Mri)

Background: Accurately identifying and monitoring pancreatic ductal adenocarcinoma (PDA) remains a significant challenge. Whereas conventional imaging (CT and MRI) report only anatomic information, dynamic contrast-enhanced MRI (DCE-MRI) has the ability to show physiologic differences in tissue perfusion based on the kinetics of IV-contrast. We coupled DCE-MRI with data-modeling methods to obtain reproducible, high-resolution physiologic images in a series of patients with and without PDA in order to more accurately identify PDA. Methods: Patients with borderline-resectable PDA (BR-PDA) or at high-risk for PDA (HR), but without cancer were imaged with DCE-MRI. T1-weighted images were collected during IV contrast injections [Figure 1]. Both tumor and the pancreatic body or non-tumor pancreas were identified and using dual-compartment pharmacokinetic modelling, DCE-MRI parameters were quantified and compared between groups. Results: Between 6/2014 and 2/2015, 12 DCE-MRIs were completed: 9 HR and 3 BR-PDA. Significant differences in the DCE-MRI parameters blood flow (F), first-pass extraction (E), mean capillary transit-time (tc), transfer constant (Ktrans), volume of extravascular-extracellular space (Ve) and blood volume (Vb) were found in normal HR pancreases vs. the tumors in BR-PDA patients [Table 1A]. When comparing non-tumoral pancreases in both cohorts, only F, Ktrans, and Vb differed [Table 1B]. Conclusions: DCE-MRI of the pancreas is feasible and provides imaging biomarkers of vascular structure and function in both tumoral and non-tumoral pancreases which may allow for earlier and more accurate identification of PDA in these high risk populations. Citation Format: Laura E. Fischer, Matthias Schabel, Bryan Foster, Charles R. Thomas, Jr., William Rooney, Brett C. Sheppard, Erin W. Gilbert.{Authors}. Physiologic pancreatic cancer imaging using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2016 May 12-15; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2016;76(24 Suppl):Abstract nr B84.