Impact of PET/MRI in the Treatment of Pancreatic Adenocarcinoma: a Retrospective Cohort Study

Abstract

Purpose Imaging is central to the diagnosis and management of Pancreatic Ductal Adenocarcinoma (PDAC). This study evaluated if positron emission tomography (PET)/magnetic resonance imaging (MRI) elicited treatment modifications in PDAC when compared to standard of care imaging (SCI). Procedures This retrospective study included consecutive patients with PDAC who underwent 2-deoxy-2-[ 18 F]fluoro- d -glucose ([ 18 F]F-FDG) PET/MRI and SCI from May 2017 to January 2019. SCI included abdominal computed tomography (CT), MRI, and/or PET/CT. For patients who had more than one pair of PET/MRI and SCI, each management decision was independently evaluated. Treatment strategies based on each modality were extracted from electronic medical records. Follow-up was evaluated until January 2020. Results Twenty-five patients underwent 37 PET/MRI’s, mean age was 65\u2009±\u20099\xa0years and 13 (13/25, 52\xa0%) were men. 49\xa0% (18/37, 95\xa0% CI 33–64\xa0%) of the PET/MRI scans changed clinical management. Whether the SCI included a PET/CT or not did not significantly modify the probability of management change (OR\u2009=\u20090.9, 95\xa0% CI 0.2–4, p \u2009=\u20091). One hundred percent (33/33) of the available follow-up data confirmed PET/MRI findings. Conclusions PET/MRI significantly changed PDAC management, consistently across the different SCI modalities it was compared to. These findings suggest a role for PET/MRI in the management of PDAC.