Prediction of overall survival in patients with locally advanced pancreatic cancer using longitudinal diffusion-weighted MRI

Bibliographic Details
Title: Prediction of overall survival in patients with locally advanced pancreatic cancer using longitudinal diffusion-weighted MRI
Authors: Anne L. H. Bisgaard, Carsten Brink, Tine Schytte, Rana Bahij, Mathilde Weisz Ejlsmark, Uffe Bernchou, Anders S. Bertelsen, Per Pfeiffer, Faisal Mahmood
Source: Frontiers in Oncology, Vol 14 (2024)
Publisher Information: Frontiers Media S.A., 2024.
Publication Year: 2024
Collection: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: diffusion-weighted MRI, biomarker, pancreatic cancer, apparent diffusion coefficient, overall survival, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: Background and purposeBiomarkers for prediction of outcome in patients with pancreatic cancer are wanted in order to personalize the treatment. This study investigated the value of longitudinal diffusion-weighted magnetic resonance imaging (DWI) for prediction of overall survival (OS) in patients with locally advanced pancreatic cancer (LAPC) treated with stereotactic body radiotherapy (SBRT).Materials and methodsThe study included 45 patients with LAPC who received 5 fractions of 10 Gy on a 1.5T MRI-Linac. DWI was acquired prior to irradiation at each fraction. The analysis included baseline values and time-trends of the apparent diffusion coefficient (ADC) and DWI parameters obtained using a decomposition method. A multivariable Cox proportional hazards model for OS was made using best-subset selection, using cross-validation based on Bootstrap.ResultsThe median OS from the first day of SBRT was 15.5 months (95% CI: 13.2-20.6), and the median potential follow-up time was 19.8 months. The best-performing multivariable model for OS included two decomposition-based DWI parameters: one baseline and one time-trend parameter. The C-Harrell index describing the model’s discriminating power was 0.754. High baseline ADC values were associated with reduced OS, whereas no association between the ADC time-trend and OS was observed.ConclusionDecomposition-based DWI parameters indicated value in the prediction of OS in LAPC. A DWI time-trend parameter was included in the best-performing model, indicating a potential benefit of acquiring longitudinal DWI during the SBRT course. These findings support both baseline and longitudinal DWI as candidate prognostic biomarkers, which may become tools for personalization of the treatment of patients with LAPC.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2234-943X
Relation: https://www.frontiersin.org/articles/10.3389/fonc.2024.1401464/full; https://doaj.org/toc/2234-943X
DOI: 10.3389/fonc.2024.1401464
Access URL: https://doaj.org/article/28104d735b244123a85c34d678a8bda1
Accession Number: edsdoj.28104d735b244123a85c34d678a8bda1
Database: Directory of Open Access Journals
More Details
ISSN:2234943X
DOI:10.3389/fonc.2024.1401464
Published in:Frontiers in Oncology
Language:English