Abstract 1622: Role of 3d volumetric and perfusion imaging for detecting early changes in pancreatic adenocarcinoma
Authors: Rahmanuddin Syed , Borazanci Erkut , Chung Vincent , Cridebring Derek , Korn Ronald , Ho Joyce , Boswell William , Hoff Daniel Von 
Published: August 2019

Abstract
Introduction:
The aggressive nature of pancreatic cancer makes it one of the leading causes of cancer-related deaths worldwide. Survival rates remain low with standard therapy. Pancreatic adenocarcinoma accounts for nearly 90% of pancreatic malignancies, and early detection could have a major impact on disease prevention and early treatment. This study assesses the utility of CT perfusion imaging and 3D modeling for the early detection of pancreatic adenocarcinoma, as well as its role in monitoring treatment response.
Methods:
This study was a collaboration approved by the City of Hope and Honor Health institutional review boards. Thirty patients diagnosed with pancreatic adenocarcinoma who initiated treatment between 2015- 2018 were selected. Six patients treated with Neoadjuvant and Standard of care (SOC) therapy at Honor Health & 24 patients received SOC therapy alone at City of Hope. Multiphase CT imaging was performed with 2.5mm slices according to standard imaging protocol, and reconstructed into 0.625 x 1.25mm slices for 3D post-processing. Images from the picture archiving and communication system (PACS) were uploaded to advanced imaging software (GE Advantage Workstation 3.2) for volumetric analysis. 3D tumor volume and perfusion studies before and during treatment were used to detect early changes in pancreatic cancer and assess response to treatment.
Results:
Measured 3D tumor volume correlated with disease burden, and decreased with clinical response to treatment. Change in arterial vs venous phase perfusion indicates the aggressivity of tumor biologics and potential early detection imaging biomarker in pancreatic adenocarcinoma. Serial imaging in patients receiving combination neoadjuvant and SOC therapy showed decreases in tumor volume and venous vasculature, while imaging in patients receiving standard therapy showed variable responses during treatment.
Conclusion:
3D volumetric imaging biomarker is one of the clinical outcome variables which define the treatment response on follow-up imaging in both neoadjuvant therapies & SOC alone. Results of our pilot study suggest that change in 3D volume and perfusion are important imaging markers that correlate with tumor progression vs regression & define the aggressivity of the tumor. Larger studies are needed to validate the utility of imaging-based volume and perfusion analysis for detecting early changes in pancreatic cancer.
Special thanks to:
1. made possible by the Kemper and Ethel Marley Foundation
2. Stand Up To Cancer-care Research UK-Lustgarten Foundation Pancreatic Cancer Dream Team Research Grant ( Grant number SU2C-AACR-DT-20-16)
Citation Format: Syed Rahmanuddin, Erkut Borazanci, Vincent Chung, Derek Cridebring, Ronald Korn, Joyce Ho, William Boswell, Daniel Von Hoff. Role of 3d volumetric and perfusion imaging for detecting early changes in pancreatic adenocarcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1622.