ArticleWorld journal of gastroenterology2025
Preoperative risk stratification of early recurrence in resected pancreatic ductal adenocarcinoma: Novel equilibrium-phase-computed tomography biomarker of extracellular volume.
Article in World journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Quantitative dual-energy computed tomography parameters as imaging biomarkers for assessing the histopathologic grade of colorectal cancer.Quantitative imaging in medicine and surgery · 2026Article
- The value of extracellular volume based on spectral CT in lymph node metastasis, perineural invasion, and lymphovascular invasion of colon cancer.Abdominal radiology (New York) · 2026Article
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7 authors.
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Abstract
backgroundPredicting early recurrence (ER), (≤ 12 months) after pancreatic ductal adenocarcinoma (PDAC) resection remains challenging. Preoperative biomarkers such as carbohydrate antigen 19-9 (CA19-9) and computed tomography (CT) lack optimal specificity and reproducibility. Extracellular volume (ECV), measured on equilibrium-phase CT to quantify stromal fibrosis, correlates with PDAC progression but its utility for ER prediction is unknown. This study evaluates preoperative CT-ECV as a novel biomarker to predict ER following curative-intent PDAC resection.
aimTo investigate the utility of CT-ECV for preoperative prediction of ER in PDAC patients after R0 resection.
methodsThis retrospective study included 93 PDAC patients undergoing R0 resection and preoperative pancreatic CT from January 2020 to November 2023. Clinical and CT features were analyzed. ECV was calculated using unenhanced and equilibrium-phase CT. Univariable and multivariable Cox regression identified ER predictors, followed by receiver operating characteristic analysis. Recurrence-free survival (RFS) was assessed by the Kaplan-Meier method.
resultsMultivariable analysis identified elevated CT-ECV [hazard ratio (HR) = 1.05; 95% confidence interval (CI): 1.02-1.09;
conclusionCT-derived ECV is a promising non-invasive biomarker for preoperative ER prediction in PDAC. Combined with CA19-9, it outperforms tumor grade in stratifying recurrence risk, offering a clinically actionable tool for optimizing postoperative management.
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