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PET/MRI biomarkers guide personalized treatment for people with PC

Posted by Qwerty @mavisann, Dec 22, 2024

PET/MRI biomarkers guide personalized treatment for people with pancreatic cancer, study finds - Mayo Clinic Comprehensive Cancer Center Blog
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https://cancerblog.mayoclinic.org/2022/01/13/pet-mri-biomarkers-guide-personalized-treatment-for-people-with-pancreatic-cancer-study-finds/
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Some items of note:

Positron emission tomography (PET)/MRI has changed how Mayo Clinic specialists treat patients with pancreatic cancer.

A PET scan can often detect the abnormal metabolism of the tracer in diseases before the disease shows up on other imaging tests, such as computerized tomography (CT) and magnetic resonance imaging (MRI).

In less than five years, Mayo's PET/MRI practice has grown from a brand-new technology with unknown promise to the most important imaging available to treat pancreatic cancer.

Mayo added its first PET/MRI scanner in 2015 in Rochester, with additional scanners added in Arizona in 2016 and Florida in 2017.

Pancreatic cancer imaging has been one of the primary drivers behind significant growth in PET/MRI.

"It has revolutionized what we do," says Mark Truty, M.D., a hepatobiliary and pancreatic surgeon at Mayo Clinic.

"We can see the tumor die on the PET/MRI scan images," Dr. Truty says. "From the patient perspective, if you're going to get chemotherapy that has side effects, you better be sure it's doing what we think it's doing. And that's what the PET scan allows us to determine much better than a regular CT scan."

The study team determined that PET/MRI provides a noninvasive selection tool to decide whether a surgery will benefit the patient in the long run, and whether a timely switch to alternate treatment regimens could optimize a patient's chances for favorable long-term outcomes.

"We've probably done over 1,000 PET/MRIs. In this particular study, we found that the PET/MRI was much better in predicting how cancer would respond than regular CT scans or blood tests that we normally would use. And that's how this is really changing the practice," Dr. Truty says. "The first thing I want to see after my first visit with the patient after they get their first rounds of chemotherapy is what is the PET/MRI telling me? And then we make significant treatment decisions based on that PET scan."

Interested in more discussions like this? Go to the Pancreatic Cancer Support Group.

stageivsurvivor | @stageivsurvivor | Dec 23, 2024

Looking at the other side of the issue, not having a PET scan done when I was diagnosed in June 2012 saved my life. Had a PET scan been performed by my Whipple done within 2.5 days of diagnosis, I would not be a 12.5 year survivor of stage IV metastatic disease to the liver.

Surgery was quickly scheduled because the CT showed the tumor was very close to the portal vein giving the surgeons a very small window of opportunity. When I was opened on the table, it was observed the tumor was in contact with the portal vein requiring it be resected along with the Whipple procedure. Surgical pathology showed the tumor had penetrated the vascular wall and had been seeding my liver with metastatic cells. The micrometastatic disease in the liver was below the detection threshold of a CT and was detected seven days later on a post-surgical CT.

Had the micrometastatic disease to the liver been detected had a PET scan occurred, the Whipple and portal vein resection would not have occurred. Care team members estimated death would have resulted within 12 months from the portal vein becoming occluded, varices forming to carry blood around that point and eventually hemorrhaging to death as the varices can not handle the higher pressure that the portal vein can.

I would not have gotten the personal treatment required to save my life. The prevailing attitude would have been stage IV, no surgery, treat according to decision of the tumor board based on established protocols. I often think of the saying, “Be careful what you wish for, because you might just get it”

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1 reply
Qwerty | @mavisann | Dec 23, 2024
In reply to @stageivsurvivor "Looking at the other side of the issue, not having a PET scan done when I..." + (show)
@stageivsurvivor

Looking at the other side of the issue, not having a PET scan done when I was diagnosed in June 2012 saved my life. Had a PET scan been performed by my Whipple done within 2.5 days of diagnosis, I would not be a 12.5 year survivor of stage IV metastatic disease to the liver.

Surgery was quickly scheduled because the CT showed the tumor was very close to the portal vein giving the surgeons a very small window of opportunity. When I was opened on the table, it was observed the tumor was in contact with the portal vein requiring it be resected along with the Whipple procedure. Surgical pathology showed the tumor had penetrated the vascular wall and had been seeding my liver with metastatic cells. The micrometastatic disease in the liver was below the detection threshold of a CT and was detected seven days later on a post-surgical CT.

Had the micrometastatic disease to the liver been detected had a PET scan occurred, the Whipple and portal vein resection would not have occurred. Care team members estimated death would have resulted within 12 months from the portal vein becoming occluded, varices forming to carry blood around that point and eventually hemorrhaging to death as the varices can not handle the higher pressure that the portal vein can.

I would not have gotten the personal treatment required to save my life. The prevailing attitude would have been stage IV, no surgery, treat according to decision of the tumor board based on established protocols. I often think of the saying, “Be careful what you wish for, because you might just get it”

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That maybe the case, we are all a sample size of one.
I have been so thankful that things worked out exactly like they did for you.
I can not appreciate the difficulty and anguish you went through for so long to get where you are today but I know that you have touched the lives and helped countless thousands and thousands and thousands of people with your story and encouragement and your selfless advice and advocacy.
Pancreatic cancer patients and the medical community are so much better off today because of you and your passion for improving treatments, knowledge and helping people.
You literally turned a negative thing for you into a positive thing for others, that says something wonderful about you.
The world is a much better place today because of you and how you handled adversity.
You’re on a mission to help people and give many people hope when they feel they don’t have any.
Congratulations and thank you, thank you, thank you.

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