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Three-dimensional magnetic resonance elastography for evaluating chemotherapy response and survival in advanced pancreatic cancer
DU Bai  SHI Yu 

Cite this article as: DU B, SHI Y. Three-dimensional magnetic resonance elastography for evaluating chemotherapy response and survival in advanced pancreatic cancer[J]. Chin J Magn Reson Imaging, 2025, 16(5): 14-21. DOI:10.12015/issn.1674-8034.2025.05.003.


[Abstract] Objective To investigate the clinical utility of baseline three-dimensional magnetic resonance elastography (3D-MRE) viscoelastic parameters in evaluating chemotherapy response and prognosis in patients with advanced pancreatic cancer (APC).Materials and Methods This prospective study enrolled patients with histologically confirmed APC between January 2022 and June 2024, all of whom underwent 3D-MRE scans prior to chemotherapy. Chemotherapy response was categorized into responders and non-responders based on RECIST 1.1 criteria. The Youden index was used to determine the optimal cut-off values for imaging parameters in predicting chemotherapy response. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of chemotherapy response, while Cox proportional hazards models were used to analyze factors influencing progression-free survival (PFS) and overall survival (OS).Results A total of 59 patients were included, with 21 in the responder group and 38 in the non-responder group. The area under the curve (AUC) for baseline shear stiffness (SS) in diagnosing chemotherapy response was 0.771 (95% CI: 0.640 to 0.902), with an optimal cutoff value of 3.85 kPa. Multivariate logistic regression analysis identified SS ≥ 3.85 kPa as an independent predictor of poor chemotherapy response [odds ratio (OR) = 6.760, 95% CI: 1.197 to 38.174, P=0.030]. Cox regression analysis revealed that SS ≥ 3.85 kPa was independently associated with shorter OS [hazard ratio (HR) = 4.217, 95% CI: 1.796 to 9.889, P=0.001] and PFS (HR = 3.860, 95% CI: 1.801 to 8.273, P=0.001). Patients with SS ≥ 3.85 kPa had significantly shorter PFS (P < 0.001) and OS (P < 0.001).Conclusions Baseline SS measured by 3D-MRE is an independent predictor of chemotherapy response in APC patients, with higher baseline SS associated with poorer prognosis. As a non-invasive and quantitative biomechanical assessment tool, 3D-MRE holds promise as an important adjunct for personalized treatment in pancreatic cancer.
[Keywords] pancreatic ductal adenocarcinoma；advanced pancreatic cancer；magnetic resonance elastography；shear stiffness；chemotherapy；prognosis

DU Bai   SHI Yu*  

Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China

Corresponding author: SHI Y, E-mail: 18940259980@163.com

Conflicts of interest   None.

Received  2025-02-25
Accepted  2025-04-16
DOI: 10.12015/issn.1674-8034.2025.05.003
Cite this article as: DU B, SHI Y. Three-dimensional magnetic resonance elastography for evaluating chemotherapy response and survival in advanced pancreatic cancer[J]. Chin J Magn Reson Imaging, 2025, 16(5): 14-21. DOI:10.12015/issn.1674-8034.2025.05.003.

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