ArticleEuropean radiology2026
Quantitative dynamic contrast-enhanced magnetic resonance imaging for early assessment of treatment response in pancreatic ductal adenocarcinoma.
Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo prospectively evaluate whether quantitative DCE-MRI can predict early chemotherapy response in pancreatic ductal adenocarcinoma (PDAC), and to assess the added value of a point-of-care portable perfusion phantom (P4) for correcting scanner-dependent errors. MATERIALS AND
methodsFifty-four patients with biopsy-confirmed PDAC were prospectively enrolled at two institutions; 42 completed MRI scans at baseline (1 ± 1 weeks before chemotherapy) and 7 ± 2 weeks after treatment initiation. P4s were imaged concurrently to correct for scanner-dependent measurement errors. Eleven pharmacokinetic (PK) parameters were derived using Tofts, extended Tofts, and shutter speed models. Treatment response at 17 ± 4 weeks was assessed using the modified RECIST, with responders defined as patients with > 10% tumor size reduction. Early changes in PK parameters were analyzed using receiver operating characteristic curves to assess predictive accuracy, and differences between responders and non-responders were assessed using one-way ANOVA.
resultsAmong 42 patients (median age 67 years; 27 males), 20 were responders and 22 non-responders. Early changes in K
conclusionQuantitative DCE-MRI enables early, highly accurate prediction of chemotherapy response in PDAC, and P4-based error correction further enhances reliability. This approach offers a prospectively validated imaging biomarker that can support timely, personalized treatment decisions for patients with PDAC. KEY POINTS: QuestionCan quantitative dynamic contrast-enhanced MRI accurately identify early chemotherapy response in PDAC before conventional morphologic changes become apparent on CT? FindingsP4-corrected quantitative DCE-MRI predicted 17-week tumor response with up to 98% accuracy after only 7 weeks of chemotherapy treatment. Clinical relevanceP4-corrected quantitative DCE-MRI may enable earlier identification of ineffective chemotherapy in pancreatic cancer, supporting timely treatment modification, reducing unnecessary toxicity, and facilitating more personalized patient management.
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