Molecular imaging in pancreatic cancer – A roadmap for therapeutic decisions

• PDAC is a desmoplastic and deadly cancer that is notoriously resistant to therapy.
• Endoscopic ultrasonography (EUS) with biopsy is crucial for PDAC diagnosis.
• Radionuclide imaging using PET and 18F-FDG is showing increasing promise.
• PET imaging is especially helpful for evaluating distant metastases.
• There is a need for novel biomarkers specific for PDAC.

Pancreatic ductaladeno carcinoma (PDAC) is a deadly cancer characterized by multiple molecular alterations, the presence of an intense stroma, poor perfusion, and resistance to therapy. In addition to standard imaging techniques, experimental imaging strategies, such as those utilizing molecular probes, nanoparticle-based agents, and tagged antibodies are actively being explored experimentally. It is hoped that advances in these technologies will allow for detecting PDAC at an early stage, and could serve to validate experimental therapies, rapidly identify non-responders, and assist in the design of novel therapeutic strategies tailored to the patient’s molecular profile.