Innovative Imaging Techniques Used to Evaluate Borderline-Resectable Pancreatic Adenocarcinoma

A diagnosis of pancreatic cancer carries a 5-y survival rate of less than 10%. Furthermore, the detection of pancreatic cancer occurs most often in later stages of the disease due to its location in the retroperitoneum and lack of symptoms (in most cases) until tumors become more advanced. Once diag...

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Bibliographic Details
Published in:The Journal of surgical research 2023-04, Vol.284, p.42-53
Main Authors: Chalfant, Hunter, Bonds, Morgan, Scott, Kristina, Condacse, Anna, Dennahy, Isabel S., Martin, W. Taylor, Little, Cooper, Edil, Barish H., McNally, Lacey R., Jain, Ajay
Format: Article
Language:English
Subjects:
Adenocarcinoma - diagnostic imaging
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Diagnostic Imaging
Fluorescence
Humans
Image-guided surgery
Neoplasm Staging
Optoacoustic imaging
Pancreatectomy - methods
Pancreatic cancer
Pancreatic Neoplasms
Pancreatic Neoplasms - diagnostic imaging
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - surgery
Resectability
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Summary:A diagnosis of pancreatic cancer carries a 5-y survival rate of less than 10%. Furthermore, the detection of pancreatic cancer occurs most often in later stages of the disease due to its location in the retroperitoneum and lack of symptoms (in most cases) until tumors become more advanced. Once diagnosed, cross-sectional imaging techniques are heavily utilized to determine the tumor stage and the potential for surgical resection. However, a major determinant of resectability is the extent of local vascular involvement of the mesenteric vessels and critical tributaries; current imaging techniques have limited capacity to accurately determine vascular involvement. Surrounding inflammation and fibrosis can be difficult to discriminate from viable tumor, making determination of the degree of vascular involvement unreliable. New innovations in fluorescence and optoacoustic imaging techniques may overcome these limitations and make determination of resectability more accurate. These imaging modalities are able to more clearly discern between viable tumor tissue and non-neoplastic inflammation or desmoplasia, allowing clinicians to more reliably characterize vascular involvement and develop individualized treatment plans for patients. This review will discuss the current imaging techniques used to diagnose pancreatic cancer, the barriers that current techniques raise to accurate staging, and novel fluorescence and optoacoustic imaging techniques that may provide more accurate clinical staging of pancreatic cancer.
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2022.10.008