Borderline-resectable pancreatic cancer (BRPC) accounts for nearly 20% of all pancreatic cancer cases diagnosed in the U.S. These tumors are often attached to nearby arteries or veins, making surgery difficult and risky. However, chemotherapy can shrink tumors, sometimes making surgery a viable option. Currently, two main chemotherapy regimens are used for BRPC, but there is no clear evidence favoring one over the other.
Harrison Kim, Ph.D., MBA, professor in the UAB Department of Radiology, and Bassel El-Rayes, M.D., director of the Division of Hematology and Oncology, have received an R01 grant from the National Cancer Institute to study whether a new device can improve the precision measurement of blood flow in tumors after chemotherapy treatment in BRPC.
In medical imaging, a phantom is a device that simulates human tissue, allowing for the testing and calibration of imaging equipment.
In a pilot study, experts used the Point-of-Care Portable Perfusion Phantom™ (P4 Phantom ™), developed at UAB, to reduce variability in quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) measurements, ensuring consistent and reliable data by correcting errors in MRI imaging.
“The P4 Phantom works like a ruler behind a mug shot. Just as a ruler chart allows us to determine a person’s height, the P4 Phantom ensures consistent and accurate DCE-MRI measurements, regardless of equipment or imaging conditions,” said Dr. Kim.
The pilot study tracked 20 pancreatic cancer patients before and up to eight weeks after starting chemotherapy. The researchers found that using the tool enabled them to distinguish between tumors that responded to chemotherapy and those that did not, achieving 100% accuracy.
In a new clinical trial, researchers are using DCE-MRI along with the P4 Phantom to better assess tumor response to chemotherapy.
The trial is testing whether DCE-MRI-guided chemotherapy can improve surgery outcomes for BRPC patients. Researchers are comparing the rate of successful surgeries in patients who received DCE-MRI-guided chemotherapy to a control group that received standard treatment. The goal is to determine if this approach increases the likelihood of successful resection.
“This trial addresses a very important clinical question: How can we better evaluate the benefit of chemotherapy in patients with BRPC?” explained Dr. El-Rayes. “The answer to this question will influence chemotherapy selection and help personalize treatment based on DCE-MRI measurements of response.”
Additionally, researchers will evaluate whether quantitative DCE-MRI can be a reliable tool for assessing changes in the pancreatic tumor microenvironment after correcting imaging data with the P4 Phantom.
This multicenter trial also involves a third principal investigator, Ashiq Masood, M.D., associate professor of medicine at Indiana University’s Melvin and Bren Simon Comprehensive Cancer Center.