Impact of EOB-MRI on the outcome of patients with pancreatic cancer in real-world settings

Contrast-enhanced computed tomography (CE-CT) is commonly used for detecting local extension and distant metastasis in pancreatic cancer (PaC) patients preoperatively. However, unexpected distant metastases often remain undetected by CE-CT, leading to unsuitable surgical treatments. Gadoxetate disodium-enhanced MRI (EOB-MRI) has shown improved detection of liver metastases, but its clinical benefit when added to CE-CT is unclear. This study evaluated the effectiveness of adding EOB-MRI before treatment on overall survival (OS) in PaC patients in real-world settings.

A retrospective cohort study using a nationwide hospital-claims database in Japan included patients aged 18 and older, diagnosed with PaC, and recorded for surgery, radiotherapy, or chemotherapy. Patients were divided into EOB-MRI and no EOB-MRI groups and further into surgery, no surgery, and openclose laparotomy subgroups. OS was compared between propensity-score matched EOB-MRI and no EOB-MRI groups using the Cox regression model. Among 39,624 patients, 4,477 (11.3%) underwent EOB-MRI before initial treatment. The study found that EOB-MRI was associated with significantly higher OS in patients who did not undergo surgery, but no difference in OS was observed in those who underwent surgery (Table. 1). These findings suggest early detection of micro hepatic metastases through EOB-MRI and its use in multidisciplinary treatment may improve outcomes in PaC patients.