Clinical significance of gadoxetate sodium-enhanced MRI for detecting liver metastasis in patients with pancreatic cancer: decadal real-world data analysis in Japan.

BACKGROUND: Precise, early diagnosis of liver metastasis improves clinical outcomes in patients with pancreatic cancer. While gadoxetate sodium-enhanced magnetic resonance imaging (EOB-MRI) may offer additional benefits in detecting liver metastases in patients with pancreatic cancer, it is still unclear whether the addition of this imaging modality to contrast-enhanced computed tomography (CE-CT) confers clinical benefits regarding prognosis and access to appropriate treatments. The objective is to evaluate the treatment pathway of patients with or without EOB-MRI after a pancreatic cancer diagnosis and examine whether the addition of EOB-MRI is associated with improved survival.

METHODS: A retrospective cohort study was conducted using a Japanese hospital-based administrative database. Patients aged ≥ 18 years and diagnosed with pancreatic cancer between 2011 and 2021 with any record of CE-CT or MRI were included. Patients were stratified based on a record of EOB-MRI (EOB-MRI vs. non-EOB-MRI). Main outcomes were treatment pathway and overall survival (OS). OS was compared between the EOB-MRI and non-EOB-MRI groups using Cox proportional hazard regression models in the propensity-score-matched cohort.

RESULTS: A total of 39,624 patients were included. The proportion of neoadjuvant chemotherapy increased to 13.4% during recent years (2019-2021) in the EOB-MRI group versus 7.8% in the non-EOB-MRI group. Significantly longer OS in the matched cohort was observed (HR [95% CI] = 0.88 [0.83-0.94]) in the EOB-MRI group (1,442 days [1275-1604]) versus the non-EOB-MRI group (1,293 days [1187-1440]).

CONCLUSIONS: The addition of EOB-MRI was associated with increased survival times in patients with pancreatic cancer.