The following list has been reviewed and approved by the European Society of Gastrointestinal and Abdominal Radiology (ESGAR).

PANCREAS

Biomarkers

Level of evidence

Single centre/ Multicentre/ metaanalysis

Retrospective (R)

Prospective (P)

Indication

Patient prep

Data acquisition requirements

Image processing algorithm

Biomarkers in development/ not recommended

ADC 1!

2b

Single center

P

Predictive of response to CT

No

2 b value: 400 and 1000

ROI, Manual delineation

ADC 2!

2b

Single center

 

P

Predictive of histologic response to CT

No

3b values: 0,50,800

Manual delineation by trained observers

ADC 3!

2b

Single center

 

P

Predictive of histologic response to CT

No

4b values: 0,100, 500, 800

Manual delineation by trained observers

VOI, histogram analysis

ADC, IVIM derived parameters4!

2b

Single center

 

P

Early Predictor of response to CT

No

9b values:0 ,10,20,30,40,50,150,300,1000

 

Manual delineation by trained observer

VOI, histogram analysis

ADC5!

2b

Single center

 

P

Predictor of OS

No

2 b value: 0 and 600

ROI, Manual delineation

(single slice)

ADC6!

2b

Single center

 

P

Predictor of OS

No

3 b value: 50, 300, 600

ROI, Manual delineation

(single slice)

ADCmin8!

2b

Single center

 

P

Predictor of OS

No

3 b value: 0, 600, 1000

ROI, Manual delineation

(single slice)

DWI-volume4!

2b

Single center

 

P

Early Predictor of response to CT

No

9b values:0 ,10,20,30,40,50,150,300,1000

 

Manual delineation by trained observer

VOI, histogram analysis

ADC7!

2b

Single center

 

P

Correlation with fibrosis

No

2 b value: 0 and 1000

ROI, manual delineation by trained observers (single slice)

ADC6, 9!

2b

Single center

 

P

Correlation with fibrosis

No

2 b value: 0 and 500

ROI, manual delineation by trained observers (single slice)

D10!

2b

Single center

P

Correlation with fibrosis

No

11b values: 0,25,50,75,100,150,200,300,400,600,800

VOI,  manual delineation by trained observers

Ktrans, vi,vp11!

2b

Single center

P

Correlation with fibrosis and MVD

No

DCE

One comp  and Modified  two-compTofts model analysis

IVIM derived parameters12!

2b

Single center

P

Correlation with fibrosis and cellular density

No

10b values: 0,25,50,75,100,150,200,400,600,800

ROI,  manual delineation by trained observers

IVIM derived parameters13, 15!

2b

Single center

P

Differentiation benign/malignant

No

11b values13-14!(as per ref 112)

11 b values: 0,10,20,30,50,70,100,150,200,400,

80015!

VOI,  manual delineation by trained observers 13-14!(as per ref 12)

ROI,  manual delineation by trained observers 15!

IVIM derived parameters16!

2b

Single center

R

Differentiation benign/malignant

No

 

10 b values: 0,25,50,75,100,150,200,500,

800, 1000

 

ROI,  manual delineation by trained observers

IVIM derived parameters17!

2b

Single center

R

Differentiation benign/malignant

No

 

10 b values: 0,10, 25,50,75,100,200,400,

600, 900

 

ROI, manual delineation by trained observers

ADC18, 7!

2b

Single center

R

Correlation with Tumour grade

No

2 b value: 0 and 1000

2 b value: 0 and 500

 

 

Manual delineation by trained observer

Ktrans, BV19!

2b

Single center

R

Predictive of response to Treatment

No

CT perfusion

Manual delineation by trained observer

 

Ktrans, Kep, ve20!

2b

Single center

P

Predictive of response to Treatment

No

DCE

Two-comp model analysis

 

Ktrans21!

2b

Single center

P

Predictive of response to Treatment

No

DCE

Two-comp model analysis (tofts)

 

 

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  2. Okada KI1, Hirono S1, Kawai M1, Miyazawa M1, Shimizu A1, Kitahata Y1, Ueno M1, Hayami S1, Kojima F2, Yamaue H1 Value of apparent diffusion coefficient prior to neoadjuvant therapy is a predictor of histologic response in patients with borderline resectable pancreatic carcinoma. J Hepatobiliary Pancreat Sci. 2017 Mar;24(3):161-168
  3. A pilot study of diffusion-weighted MRI in patients undergoing neoadjuvant chemoradiation for pancreatic cancer Cuneo KC, Chenevert TL, Ben-Josef E, Feng MU, Greenson JK, Hussain HK, Simeone DM, Schipper MJ, Anderson MA, Zalupski MM, Al-Hawary M, Galban CJ, Rehemtulla A, Feng FY, Lawrence TS, Ross BD. Transl Oncol. 2014 Oct 24;7(5):644-9.
  4. Bali MA, Pullini S, Metens T, Absil J, Chao SL, Marechal R, Matos C, Peerboccus BM, Van Laethem JL. Assessment of response to chemotherapy in pancreatic ductal adenocarcinoma: Comparison between diffusion-weighted MR quantitative parameters and RECIST Eur J Radiol. 2018 Jul;104:49-57.
  5. Pre-treatment DWI as a predictor of overall survival in locally advanced pancreatic cancer treated with Cyberknife radiotherapy and sequential S-1 therapy. Zhang Y, Zhu X, Liu D, Song J, Zhang H, Lu J. Cancer Imaging. 2018 Feb 22;18(1):6.
  6. Heid I, Steiger K, Trajkovic-Arsic M, Settles M, Eßwein MR, Erkan M, Kleeff J, Jäger C, Friess H Co-clinical Assessment of Tumor Cellularity in Pancreatic Cancer. Clin Cancer Res. 2017 Mar 15;23(6):1461-1470.
  7. Ma W1, Li N, Zhao W, Ren J, Wei M, Yang Y, Wang Y, Fu X, Zhang Z, Larson AC, Huan Y. Apparent Diffusion Coefficient and Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Pancreatic Cancer: Characteristics and Correlation With Histopathologic Parameters. J Comput Assist Tomogr. 2016 Sep-Oct;40(5):709-16
  8. Chen BB, Tien YW, Chang MC, Cheng MF, Chang YT, Yang SH, Wu CH, Kuo TC, Shih IL, Yen RF, Shih TT. Multiparametric PET/MR imaging biomarkers are associated with overall survival in patients with pancreatic cancer. Eur J Nucl Med Mol Imaging. 2018 Jul;45(7):1205-1217.
  9. Muraoka N, Uematsu H, Kimura H, Imamura Y, Fujiwara Y, Murakami M, Yamaguchi A, Itoh H. Apparent diffusion coefficient in pancreatic cancer: characterization and histopathological correlations. J Magn Reson Imaging. 2008 Jun;27(6):1302-8.
  10. Klauß M, Gaida MM, LemkeA, Gru ̈nberg K, Simon D, Wente MN, Delorme S, Kauczor HU, Grenacher L, Stieltjes, B Fibrosis and Pancreatic Lesions Invest Radiol 2013;48: 129Y133
  11. Bali MA, Metens T, Denolin V, Delhaye M, Demetter P, Closset J, Matos C. Tumoral and nontumoral pancreas: correlation between quantitative dynamic contrast-enhanced MR imaging and histopathologic parameters. Radiology. 2011 Nov;261(2):456-66
  12. Hecht EM1, Liu MZ1, Prince MR1, Jambawalikar S1, Remotti HE2, Weisberg SW2, Garmon D3, Lopez-Pintado S4, Woo Y5, Kluger MD3, Chabot JA3. Can diffusion-weighted imaging serve as a biomarker of fibrosis in pancreatic adenocarcinoma? J Magn Reson Imaging. 2017 Aug;46(2):393-402
  13. Lemke A, Laun FB, Klauss M, Re TJ, Simon D, Delorme S, Schad LR, Stieltjes B. Differentiation of pancreas carcinoma from healthy pancreatic tissue using multiple b-values: comparison of apparent diffusion coefficient and intravoxel incoherent motion derived parameters. Invest Radiol. 2009 Dec;44(12):769-75.
  14. Klauss M, Lemke A, Grünberg K, Simon D, Re TJ, Wente MN, Laun FB, Kauczor HU, Delorme S, Grenacher L, Stieltjes B. Intravoxel incoherent motion MRI for the differentiation between mass forming chronic pancreatitis and pancreatic carcinoma. Invest Radiol. 2011 Jan;46(1):57-63
  15. De Robertis R, Cardobi N, Ortolani S, Tinazzi Martini P, Stemmer A, Grimm R, Gobbo S, Butturini G, D'Onofrio M Intravoxel incoherent motion diffusion-weighted MR imaging of solid pancreatic masses: reliability and usefulness for characterization. Abdom Radiol (NY). 2018 Jun 28.
  16. Kang KM, Lee JM, Yoon JH, Kiefer B, Han JK, Choi BI. Intravoxel incoherent motion diffusion-weighted MR imaging for characterization of focal pancreatic lesions. Radiology. 2014 Feb;270(2):444-53
  17. Kim B, Lee SS, Sung YS, Cheong H, Byun JH, Kim HJ, Kim JH. Intravoxel incoherent motion diffusion-weighted imaging of the pancreas: Characterization of benign and malignant pancreatic pathologies. J Magn Reson Imaging. 2017 Jan;45(1):260-269.
  18. Wang Y, Chen ZE, Nikolaidis P, McCarthy RJ, Merrick L, Sternick LA, Horowitz JM, Yaghmai V, Miller FH Diffusion-weighted magnetic resonance imaging of pancreatic adenocarcinomas: association with histopathology and tumor grade. J Magn Reson Imaging. 2011 Jan;33(1):136-42
  19. Park MS, Klotz E, Kim MJ, Song SY, Park SW, Cha SW, Lim JS, Seong J, Chung JB, Kim KW. Perfusion CT: noninvasive surrogate marker for stratification of pancreatic cancer response to concurrent chemo- and radiation therapy. Radiology. 2009 Jan;250(1):110-7
  20. Akisik MF, Sandrasegaran K, Bu G, Lin C, Hutchins GD, Chiorean EG. Pancreatic cancer: utility of dynamic contrast-enhanced MR imaging in assessment of antiangiogenic therapy. Radiology. 2010 Aug;256(2):441-9
  21. Kim H, Morgan DE, Schexnailder P, Navari RM, Williams GR, Bart Rose J, Li Y, Paluri R. Accurate Therapeutic Response Assessment of Pancreatic Ductal Adenocarcinoma Using Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging With a Point-of-Care Perfusion Phantom: A Pilot Study. Invest Radiol. 2018 Aug 22.