Looking at or beyond the tumor - a systematic review and meta-analysis of quantitative imaging biomarkers predicting pancreatic cancer prognosis

IF 2.2 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Abdominal Radiology Pub Date : 2025-04-08 DOI:10.1007/s00261-025-04919-7

Zihe Wang, Liang Zhu, Yitan Wang, Xianlin Han, Qiang Xu, Menghua Dai

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引用次数: 0

Abstract

Objectives

To evaluate the prognostic value of quantitative imaging biomarkers derived from computed tomography (CT) and magnetic resonance imaging (MRI) for pancreatic cancer (PC), with a particular focus on body composition parameters beyond the traditional intrinsic features of the tumor.

Methods

PubMed, EMBASE, and Cochrane Library databases were searched for articles on quantitative imaging biomarkers obtained from CT or MRI in predicting PC prognosis published between January 2014 and August 2024. The Newcastle-Ottawa scale was used to assess the quality of the included studies. Survival outcomes, such as overall survival (OS) and recurrence-free survival (RFS), were evaluated. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. In case of high heterogeneity, subgroup analyses and sensitivity analyses were performed to identify potential sources of heterogeneity among the studies.

Results

We performed a meta-analysis of ten imaging biomarkers investigated in 43 included studies. Larger tumor size, lower skeletal muscle radiodensity, lower skeletal muscle index (SMI), presence of sarcopenic obesity, lower psoas muscle index (PMI), higher visceral to subcutaneous adipose tissue area ratio, and lower visceral adipose tissue index were associated with significantly worse OS. In particular, lower SMI and lower PMI had relatively high HRs (1.65 for SMI, 95% CI 1.39–1.96, and 2.20 for PMI, 95% CI 1.74–2.78). Patients with lower SMI exhibited poorer RFS (HR 1.78, 95% CI 1.46–2.18). Subgroup analyses identified the origin region of the study and intervention type as potential factors of heterogeneity for SMI in predicting OS.

Conclusions

Imaging biomarkers indicating body composition at PC diagnosis may play an important role in predicting patient prognosis. Further prospective multi-center studies with large sample sizes are needed for validation and translation into clinical practice.

Graphical Abstract

查看原文本刊更多论文

观察或超越肿瘤-预测胰腺癌预后的定量成像生物标志物的系统回顾和荟萃分析。

目的：评估来自计算机断层扫描（CT）和磁共振成像（MRI）的定量成像生物标志物对胰腺癌（PC）的预后价值，特别关注肿瘤传统固有特征之外的身体成分参数。方法：检索PubMed、EMBASE和Cochrane图书馆数据库，检索2014年1月至2024年8月发表的有关CT或MRI定量成像生物标志物预测PC预后的文章。纽卡斯尔-渥太华量表用于评估纳入研究的质量。评估生存结果，如总生存期（OS）和无复发生存期（RFS）。采用随机效应模型计算合并风险比（hr）和95%置信区间（ci）。在异质性较高的情况下，进行亚组分析和敏感性分析，以确定研究之间潜在的异质性来源。结果：我们对43项纳入研究中的10种成像生物标志物进行了荟萃分析。较大的肿瘤大小、较低的骨骼肌放射密度、较低的骨骼肌指数（SMI）、存在肌肉减少性肥胖、较低的腰肌指数（PMI）、较高的内脏与皮下脂肪组织面积比和较低的内脏脂肪组织指数与较差的OS相关。特别是，较低的SMI和较低的PMI具有相对较高的hr （SMI为1.65,95% CI 1.39-1.96， PMI为2.20,95% CI 1.74-2.78）。SMI较低的患者表现出较差的RFS （HR 1.78, 95% CI 1.46-2.18）。亚组分析确定了研究的起源地区和干预类型是SMI预测OS异质性的潜在因素。结论：影像生物标志物在PC诊断中显示的身体成分可能对预测患者预后有重要作用。需要进一步的前瞻性多中心大样本量研究来验证和转化为临床实践。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Abdominal Radiology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

8.30%

发文量

334

期刊介绍： Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section. Reasons to Publish Your Article in Abdominal Radiology: · Official journal of the Society of Abdominal Radiology (SAR) · Published in Cooperation with: European Society of Gastrointestinal and Abdominal Radiology (ESGAR) European Society of Urogenital Radiology (ESUR) Asian Society of Abdominal Radiology (ASAR) · Efficient handling and Expeditious review · Author feedback is provided in a mentoring style · Global readership · Readers can earn CME credits