The influence of modern computer and magnetic resonance imaging technologies on the preoperative staging of pancreatic cancer
Alexandra V. Zharikova,
Evgeny V. Kondratyev,
Valeriya S. Tikhonova,
Ivan S. Gruzdev,
Mikhail V. Rostovtsev,
Pavel V. Markov,
Vladimir Yu. Struchkov,
Grigory G. Karmazanovsky https://doi.org/10.24835/1607-0763-1452
Abstract
Цель исследования: обзор и анализ зарубежной и отечественной литературы, клинических рекомендаций, посвященных оценке распространенности опухоли протоковой аденокарциномы поджелудочной железы и тактике лечения пациентов с выявленным новообразованием поджелудочной железы.
Материал и методы. Проведен анализ отечественных и зарубежных источников литературы по базам PubMed с использованием ключевых слов “pancreatic cancer”, “vascular invasion”, “locally advanced cancer”, “cancer statistics”, “CT”, “MRI”, “neoadjuvant therapy” за последние 5–10 лет.
В данном обзоре рассмотрены основные методы визуализации, используемые для определения взаимоотношения опухоли с прилежащими магистральными сосудами и оценки резектабельности рака поджелудочной железы.
Заключение. Компьютерная томография и магнитно-резонансная томография с контрастным усилением – первоочередные методы диагностики протоковой аденокарциномы поджелудочной железы. Они высокоинформативны для оценки контакта/вовлечения сосудистых структур, распространенности опухолевого процесса, однако стандартные критерии неинформативны для оценки ответа на химиотерапевтическое лечение, поэтому требуется внедрение альтернативных способов его оценки, одним из которых является радиомика, лежащая в основе работы искусственного интеллекта и программ глубокого машинного обучения.
About the Authors
Alexandra V. Zharikova
A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Alexandra V. Zharikova – Resident Physician of radiology department, A.V. Vishnevsky National Medical Research Centre of Surgery, Moscow
Competing Interests:
Автор заявляет об отсутствии конфликта интересов.
Evgeny V. Kondratyev
A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Evgeny V. Kondratyev – Cand. of Sсi. (Med.), senior researcher of radiology department, A.V. Vishnevsky National Medical Research Centre of Surgery, Moscow
Competing Interests:
Автор заявляет об отсутствии конфликта интересов.
Valeriya S. Tikhonova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
Valeriya S. Tikhonova – Cand. of Sсi. (Med.), radiologist of the First Moscow State Medical University named after I.M. Sechenov, Moscow
Competing Interests:
Автор заявляет об отсутствии конфликта интересов.
Ivan S. Gruzdev
A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Ivan S. Gruzdev – Cand. of Sсi. (Med.), researcher of radiology department, A.V. Vishnevsky National Medical Research Centre of Surgery, Moscow
Competing Interests:
Автор заявляет об отсутствии конфликта интересов.
Mikhail V. Rostovtsev
A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation;
M.E. Zhadkevich City Clinical Hospital (City Hospital No71);
Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Mikhail V. Rostovtsev – Doct. of Sci. (Med.), Senior Researcher, Department of Radiation Diagnostic Methods, A.V. Vishnevsky National Medical Research Center of Surgery; Professor of the Department of Radiology and Roentgenology, Russian Medical Academy of Continuing Professional Education; Head of the Radiology Department, M.E. Zhadkevich City Clinical hospital, Moscow
Competing Interests:
Автор заявляет об отсутствии конфликта интересов.
Pavel V. Markov
A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Pavel V. Markov – Doct. of Sci. (Med.), Head of the Abdominal Surgery Department, A.V. Vishnevsky National Medical Research Center of Surgery, Moscow
Competing Interests:
Автор заявляет об отсутствии конфликта интересов.
Vladimir Yu. Struchkov
A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Vladimir Yu. Struchkov – PhD, junior researcher, Abdominal Surgery Department, A.V. Vishnevsky National Medical Research Center of Surgery, Moscow
Competing Interests:
Автор заявляет об отсутствии конфликта интересов.
Grigory G. Karmazanovsky
A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation;
Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Grigory G. Karmazanovsky – Russian Academy of Sciences (RAS) Full Member, Doct. of Sci. (Med.), Professor, Heаd of the Diagnostic Rаdiology Depаrtment at the А.V. Vishnevsky Nаtionаl Mediсаl Reseаrсh Сenter of Surgery; Professor of radiology department, Pirogov Russian national research medical university, Moscow
Competing Interests:
Автор заявляет об отсутствии конфликта интересов.
References
1. ACS Journals, Cancer statistics 2020, http://doi.org/10.3322/caac.21590
2. Malignant neoplasms in Russia in 2020 (morbidity and mortality) / Eds A.D. Kaprin, V.V. Starinsky, A.O. Shakhzadova. 2021. (In Russian)
3. Park W., Chawla A., O’Reilly E.M. Pancreatic Cancer: A Review. JAMA. 2021; 326 (9): 851–862. https://doi.org/10.1001/jama.2021.13027
4. Buchs N.C., Chilcott M., Poletti P.-A. et al. Vascular invasion in pancreatic cancer: Imaging modalities, preoperative diagnosis and surgical management. Wld J. Gastroenterol. 2010; 16 (7): 818–831. https://doi.org/10.3748/wjg.v16.i7.818
5. Al-Hawary M.M., Francis I.R., Chari S.T. et al. Pancreatic ductal adenocarcinoma radiology reporting template: consensus statement of the Society of Abdominal Radiology and the American Pancreatic Association. Radiology. 2014; 270 (1): 248–260. https://doi.org/10.1148/radiol.13131184
6. Clinical recommendations of the Ministry of Health of the Russian Federation, pancreatic cancer, 2021” https://cr.minzdrav.gov.ru/schema/355_4 (In Russian)
7. Gugenheim J., Crovetto A., Petrucciani N. Neoadjuvant therapy for pancreatic cancer. Updates Surg. 2022; 74 (1): 35–42. https://doi.org/10.1007/s13304-021-01186-1
8. Seufferlein T., Uhl W., Kornmann M. et al. Perioperative or only adjuvant gemcitabine plus nab-paclitaxel for resectable pancreatic cancer (NEONAX) – a randomized phase II trial of the AIO pancreatic cancer group. Ann. Oncol. 2023; 34 (1): 91–100. https://doi.org/10.1016/j.annonc.2022.09.161
9. Ghaneh P., Palmer D., Cicconi S. et al. Immediate surgery compared with short-course neoadjuvant gemcitabine plus capecitabine, FOLFIRINOX, or chemoradiotherapy in patients with borderline resectable pancreatic cancer (ESPAC5): a four-arm, multicentre, randomised, phase 2 trial. Lancet Gastroenterol. Hepatol. 2023; 8 (2): 157–168. https://doi.org/10.1016/S2468-1253(22)00348-X
10. NCCN Guidelines for Pancreatic Adenocarcinoma. V.1., 2023.
11. Lee E.S., Lee J.M. Imaging diagnosis of pancreatic cancer: a state-of-the-art review. Wld J. Gastroenterol. 2014; 20 (24): 7864–7877. https://doi.org/10.3748/wjg.v20.i24.7864
12. Kim Y.K., Lee M.W., Lee W.J. et al. Diagnostic Accuracy and Sensitivity of Diffusion-Weighted and of Gadoxetic Acid-Enhanced 3-T MR Imaging Alone or in Combination in the Detection of Small Liver Metastasis (≤1.5 cm in Diameter). Invest. Radiol. 2012; 47 (3): 159–66. https://doi.org/10.1097/rli.0b013e31823a1495
13. Karmazanovsky G.G. Solid Pancreatic Tumors: Staging and Resectability, Criteria for Evaluation of Tumor Progression after Surgical Treatment (Lecture, Part 2). Medical Visualization. 2016; 5: 43–49. (In Russian)
14. Schima W., Koelblmger C. Pancreatic Adenocarcinoma: Detection, Staging and Differential Diagnosis. Medical Visualization. 2015; 5: 52–72. (In Russian)
15. Vetsheva N.N. Preoperative Diagnosis of Solid Pancreatic Mass: Literature Review. Medical Visualization. 2016; 5: 50–58. (In Russian)
16. Kamisawa T., Takuma K., Anjiki H. et al. Differentiation of autoimmune pancreatitis from pancreatic cancer by diffusion-weighted MRI. Am. J. Gastroenterol. 2010; 105 (8): 1870–1875. https://doi.org/10.1038/ajg.2010.87
17. Uzunoglu F.G., Welte M.-N., Gavazzi F. et al. Evaluation of the MDACC clinical classification system for pancreatic cancer patients in an European multicenter cohort. Eur. J. Surg. Oncol. 2019; 45 (5): 793–799. https://doi.org/10.1016/j.ejso.2018.12.012
18. Sohal D.P.S., Kennedy E.B., Cinar P. et al. Metastatic Pancreatic Cancer: ASCO Guideline Update. J. Clin. Oncol. 2020; 38 (27): 3217–3230. https://doi.org/10.1200/JCO.20.01364
19. Isaji S., Mizuno S., Windsor J.A. et al. International consensus on definition and criteria of borderline resectable pancreatic ductal adenocarcinoma 2017. Pancreatology. 2018; 18 (1): 2–11. https://doi.org/10.1016/j.pan.2017.11.011
20. Pokataev I.A., Gladkov O.A., Zagainov V.E. et al. Practical recommendations for drug treatment of pancreatic cancer. Malignant tumors: Practical recommendations RUSSCO #3s2, 2022; 12: 530–544. https://doi.org/10.18027/2224-5057-2022-12-3s2-530-544 (In Russian)
21. Fujita T., Nakagohri T., Gotohda N. et al. Evaluation of the prognostic factors and significance of lymph node status in invasive ductal carcinoma of the body or tail of the pancreas. Pancreas. 2010; 39 (1): e48–54. https://doi.org/10.1097/MPA.0b013e3181bd5cfa
22. Kanda M., Fujii T., Nagai S. et al. Pattern of lymph node metastasis spread in pancreatic cancer. Pancreas. 2011; 40: 951–955. https://doi.org/10.1097/MPA.0b013e3182148342
23. Sergeant G., Melloul E., Lesurtel M. et al. Extended lymphadenectomy in patients with pancreatic cancer is debatable. Wld J. Surg. 2013; 37 (8): 1782–1788. https://doi.org/10.1007/s00268-013-2064-z
24. Zacharias T., Jaeck D., Oussoultzoglou E. et al. Impact of lymph node involvement on long-term survival after R0 pancreaticoduodenectomy for ductal adenocarcinoma of the pancreas. J. Gastrointest. Surg. 2007; 11: 350–356. https://doi.org/10.1007/s11605-007-0113-3
25. Henne-Bruns D., Vogel I., Lüttges J. et al. Surgery for ductal adenocarcinoma of the pancreatic head: staging, complications, and survival after regional versus extended lymphadenectomy. Wld J. Surg. 2000; 24 (5): 595–601; discussion 601–602. https://doi.org/10.1007/s002689910089
26. Murakami Y., Uemura K., Sudo T. et al. Prognostic factors after surgical resection for intrahepatic, hilar, and distal cholangiocarcinoma. Ann. Surg. Oncol. 2011; 18 (3): 651–658. https://doi.org/10.1245/s10434-010-1325-4
27. Henne-Bruns D., Vogel I., Lüttges J. et al. Ductal adenocarcinoma of the pancreas head: survival after regional versus extended lymphadenectomy. Hepatogastroenterology. 1998; 45 (21): 855–866. PMID: 9684147
28. Masui T., Kubota T., Aoki K. et al. Long-term survival after resection of pancreatic ductal adenocarcinoma with para-aortic lymph node metastasis: case report. Wld J. Surg. Oncol. 2013; 11 (1): 195. https://doi.org/10.1186/1477-7819-11-195
29. Kaťuchová J., Bober J., Kaťuch V., Radoňak J. Significance of lymph node micrometastasis in pancreatic cancer patients. Eur. Surg. Res. 2012; 48 (1): 10–15. https://doi.org/10.1159/000334171
30. Ishikawa O., Ohhigashi H., Sasaki Y. et al. Practical usefulness of lymphatic and connective tissue clearance for the carcinoma of the pancreas head. Ann. Surg. 1988; 208 (2): 215–220. https://doi.org/10.1097/00000658-198808000-00014
31. Nimura Y., Nagino M., Takao S. et al. Standard versus extended lymphadenectomy in radical pancreatoduodenectomy for ductal adenocarcinoma of the head of the pancreas: Long-term results of a japanese multicenter randomized controlled trial. J. Hepatobiliary. Pancreat. Sci. 2012; 19: 230–241. https://doi.org/10.1007/s00534-011-0466-6
32. Doi R., Kami K., Ito D. et al. Prognostic implication of para-aortic lymph node metastasis in resectable pancreatic cancer. Wld J. Surg. 2007; 31 (1): 147–154. https://doi.org/10.1007/s00268-005-0730-5
33. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011; 14: 101–112. https://doi.org/10.1007/s10120-011-0041-5
34. Bazin I.S., Pokataev I.A., Popova A.S. et al. The place of chemotherapy in the treatment of localized pancreatic cancer. Malignant tumors. 2016; 4 (special issue 1): 20–25. (In Russian)
35. Lambert A., Schwarz L., Ducreux M., Conroy T. Neoadjuvant Treatment Strategies in Resectable Pancreatic Cancer. Cancers (Basel). 2021; 13 (18): 4724. https://doi.org/10.3390/cancers13184724
36. Springfeld C., Ferrone C.R., Katz M.H.G. et al. Neoadjuvant therapy for pancreatic cancer. Nat. Rev. Clin. Oncol. 2023; 20 (5): 318–337. https://doi.org/10.1038/s41571-023-00746-1
37. Katz M.H., Fleming J.B., Bhosale P. et al. Response of borderline resectable pancreatic cancer to neoadjuvant therapy is not reflected by radiographic indicators. Cancer. 2012; 118 (23): 5749–5756. https://doi.org/10.1002/cncr.27636
38. Ferrone C.R., Marchegiani G., Hong T.S. et al. Radiological and surgical implications of neoadjuvant treatment with FOLFIRINOX for locally advanced and borderline resectable pancreatic cancer. Ann. Surg. 2015; 261: 12–17. https://doi.org/10.1097/SLA.0000000000000867
39. Zins M., Matos C., Cassinotto C. Pancreatic Adenocarcinoma Staging in the Era of Preoperative Chemotherapy and Radiation Therapy. Radiology. 2018; 287 (2): 374–390. https://doi.org/10.1148/radiol.2018171670
40. Chen X., Oshima K., Schott D. et al. Assessment of treatment response during chemoradiation therapy for pancreatic cancer based on quantitative radiomic analysis of daily CTs: An exploratory study. PLoS One. 2017; 12 (6): e0178961. https://doi.org/10.1371/journal.pone.0178961
41. Navez J., Bouchart C., Lorenzo D. et al. What Should Guide the Performance of Venous Resection During Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma with Venous Contact? Ann. Surg. Oncol. 2021; 28 (11): 6211–6222. https://doi.org/10.1245/s10434-020-09568-2.
42. Barreto S.G., Loveday B., Windsor J.A., Pandanaboyana S. Detecting tumour response and predicting resectability after neoadjuvant therapy for borderline resectable and locally advanced pancreatic cancer. ANZ J. Surg. 2019; 89 (5): 481–487. https://doi.org/10.1111/ans.14764
43. Yang R., Lu M., Qian X. et al. Diagnostic accuracy of EUS and CT of vascular invasion in pancreatic cancer: a systematic review. J. Cancer. Res. Clin. Oncol. 2014; 140 (12): 2077–2086. https://doi.org/10.1007/s00432-014-1728-x
44. Zimmermann C., Distler M., Jentsch C. et al. Evaluation of response using FDG-PET/CT and diffusion weighted MRI after radiochemotherapy of pancreatic cancer: a non-randomized, monocentric phase II clinical trial-PaCa-DD-041 (Eudra-CT 2009-011968-11). Strahlenther. Onkol. 2021; 197 (1): 19–26. https://doi.org/10.1007/s00066-020-01654-4
45. Nishiofuku H., Tanaka T., Marugami N. et al. Increased tumour ADC value during chemotherapy predicts improved survival in unresectable pancreatic cancer. Eur. Radiol. 2016; 26 (6): 1835–1842. https://doi.org/10.1007/s00330-015-3999-2
46. Cozzi L., Comito T., Fogliata A. et al. Computed tomography based radiomic signature as predictive of survival and local control after stereotactic body radiation therapy in pancreatic carcinoma. PLoS One. 2019; 14 (1): e0210758. https://doi.org/10.1371/journal.pone.0210758
47. Nasief H., Hall W., Zheng C. et al. Improving Treatment Response Prediction for Chemoradiation Therapy of Pancreatic Cancer Using a Combination of Delta-Radiomics and the Clinical Biomarker CA19-9. Front. Oncol. 2020; 9: 1464. https://doi.org/10.3389/fonc.2019.01464
48. Ciaravino V., Cardobi N., De Robertis R. et al. CT Texture Analysis of Ductal Adenocarcinoma Downstaged After Chemotherapy. Anticancer Res. 2018; 38 (8): 4889–4895. https://doi.org/10.21873/anticanres.12803
49. Chen F., Zhou Y., Qi X. et al. CT texture analysis for the presurgical prediction of superior mesenteric-portal vein invasion in pancreatic ductal adenocarcinoma: comparison with CT imaging features. Clin. Radiol. 2021; 76 (5): 358–366. https://doi.org/10.1016/j.crad.2021.01.003
50. Rigiroli F., Hoye J., Lerebours R. et al. CT Radiomic Features of Superior Mesenteric Artery Involvement in Pancreatic Ductal Adenocarcinoma: A Pilot Study. Radiology. 2021; 301 (3): 610–622. https://doi.org/10.1148/radiol.2021210699
51. Bian Y., Jiang H., Ma C. et al. Performance of CT-based radiomics in diagnosis of superior mesenteric vein resection margin in patients with pancreatic head cancer. Abdom. Radiol. (NY). 2020; 45 (3): 759–773. https://doi.org/10.1007/s00261-019-02401-9
52.
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For citations:
Zharikova A.V., Kondratyev E.V., Tikhonova V.S., Gruzdev I.S., Rostovtsev M.V., Markov P.V., Struchkov V.Yu., Karmazanovsky G.G. The influence of modern computer and magnetic resonance imaging technologies on the preoperative staging of pancreatic cancer. Medical Visualization. 2024;28(2):118-133. (In Russ.) https://doi.org/10.24835/1607-0763-1452
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