Modern radiological assessment after neoadjuvant therapy in pancreatic cancer: an overview

Abstract

This narrative review provides an overview of the current radiological assessment of pancreatic cancer after neoadjuvant treatment. The current literature was searched for evidence of the different radiological quantitative imaging modalities to stage pancreatic cancer. An overview is given in a narrative method. The quantitative imaging modalities comprise computed tomography (CT) perfusion, dual-energy CT, magnetic resonance imaging, and fluorodeoxyglucose positron emission tomography (FDG-PET)/CT. Radiomics analysis can be used to further characterize the tumors and to reflect the complex tumor microstructure before and after neoadjuvant treatment. Exact extension of the tumor and infiltration of the surrounding tissue is of utter importance to decide, whether the neoadjuvant treatment leads to a resectability or not. There is increasing evidence of the importance of quantitative imaging modalities to assess treatment response in patients with pancreatic cancer after neoadjuvant treatment. Prospective studies employing these modalities are needed to further investigate the benefit for the patients.