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The Role of 18F-FDG PET/CT and PET/MRI in Pancreatic Ductal Adenocarcinoma

机译:18F-FDG PET / CT和PET / MRI在胰腺导管腺癌中的作用

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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.
机译:胰腺导管腺癌(PDAC)仍然是治疗的困难疾病,并且继续预测预后差,因为大多数患者在诊断中不可切除。 18F-氟脱氧氧(FDG)正电子发射断层扫描(PET)与CT(PET / CT)联合的是不同癌症的肿瘤学成像的基石;然而,PET / CT在PDAC中的作用是不断发展的,目前尚未确定。研究表明PET / CT在引导PDAC患者的管理方面的潜力,在某些情况下,可能在具有CT或MRI的解剖学成像上增加了益处。 PET / CT可用于诊断,初始分期,治疗响应评估,从治疗后纤维化和放射治疗计划的复发性肿瘤的分化。此外,由于最初被视为外科候选者的患者,PET / CT可能是一种成本效益的模态。最近,同时PET / MRI的出现代表了在PDAC成像中具有潜在应用的杂交功能成像的激动推进。 PET / MRI的优点包括同时采集,以改善融合图像的登记,降低辐射剂量,优异的软组织对比度和多体成像的可用性。正在进行研究以评估PDAC的PET / MRI的效用,包括初始分期和治疗响应评估,并确定将从PET / MRI中受益的患者的亚组。在PET / CR和PET / MRI中有权进一步研究,以更好地了解这些模式在PDAC中的作用。

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