Combining in Vitro Diagnostics with in Vivo Imaging for Earlier Detection of Pancreatic Ductal Adenocarcinoma: Challenges and Solutions

Radiology. 2015 Dec;277(3):644-61. doi: 10.1148/radiol.2015141020.

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is the fourth-leading cause of cancer-related death in the United States and is associated with a dismal prognosis, particularly when diagnosed at an advanced stage. Overall survival is significantly improved if PDAC is detected at an early stage prior to the onset of symptoms. At present, there is no suitable screening strategy for the general population. Available diagnostic serum markers are not sensitive or specific enough, and clinically available imaging modalities are inadequate for visualizing early-stage lesions. In this article, the role of currently available blood biomarkers and imaging tests for the early detection of PDAC will be reviewed. Also, the emerging biomarkers and molecularly targeted imaging agents being developed to improve the specificity of current imaging modalities for PDAC will be discussed. A strategy incorporating blood biomarkers and molecularly targeted imaging agents could lead to improved screening and earlier detection of PDAC in the future. (©) RSNA, 2015.

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Biomarkers / blood*
  • Blood Proteins / analysis
  • Carcinoma, Pancreatic Ductal / diagnosis*
  • Cholangiopancreatography, Endoscopic Retrograde
  • Contrast Media
  • Cost-Benefit Analysis
  • DNA Methylation
  • Diagnostic Imaging / methods*
  • Early Detection of Cancer / methods*
  • Fluorodeoxyglucose F18
  • Humans
  • Magnetic Resonance Imaging
  • Magnetic Resonance Spectroscopy
  • MicroRNAs / blood
  • Pancreatic Neoplasms / diagnosis*
  • Positron-Emission Tomography
  • Tomography, X-Ray Computed

Substances

  • Biomarkers
  • Blood Proteins
  • Contrast Media
  • MicroRNAs
  • Fluorodeoxyglucose F18