2022 Fiscal Year Final Research Report

Prediction of aggressiveness and treatment resistance by quantification of desmoplastic change in pancreatic ductal adenocarcinoma using iodine density images

Research Project

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Project/Area Number	19K08152
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 52040:Radiological sciences-related
Research Institution	Kobe University
Principal Investigator	Sofue Keitaro 神戸大学, 医学部附属病院, 准教授 (90622027)
Co-Investigator(Kenkyū-buntansha)	村上卓道神戸大学, 医学研究科, 教授 (20252653) 上嶋英介神戸大学, 医学部附属病院, 助教 (40645561) 上野嘉子神戸大学, 医学研究科, 助教 (50625134) 増田充弘神戸大学, 医学研究科, 講師 (60512530)
Project Period (FY)	2019-04-01 – 2023-03-31
Keywords	膵癌 / 線維化定量 / 予後予測
Outline of Final Research Achievements	EVG staining to evaluate the amount of collagen and α-SMA staining to evaluate activated pancreatic stellate cells were performed on 162 patients with pancreatic ductal carcinoma who had undergone surgical resection. It was also found that pancreatic cancers with advanced fibrosis had more CD8-positive T cells in the tumor. These results suggest that pancreatic cancer patients with advanced fibrosis had better prognosis and may be related to the immune status within the tumor. In order to evaluate fibrotic stroma in detail from equilibrium phase images, we developed software for radiomic analysis based on MatLab. Quantitative measurement of iodine content in pancreatic cancer using iodine maps obtained from the equilibrium phase of contrast-enhanced CT makes it possible to noninvasively stratify poor prognosis and treatment resistance in pancreatic cancers, and may contribute to the development of treatment strategies and clarification of pathological conditions in pancreatic cancer.
Free Research Field	放射線画像診断
Academic Significance and Societal Importance of the Research Achievements	本研究結果において、膵癌においては線維化が高度な症例で予後が良く、腫瘍内免疫状態とも関連している可能性が示唆された。また、Dual-energy CTでは造影剤の停滞をより正確に定量できる可能性がファントム実験ならびに臨床患者の検討において証明された。造影CTの平衡相から得られるヨードマップを用いて膵癌内部のヨード量を定量測定することで膵癌の中でも特に予後不良で治療抵抗性な症例を非侵襲的に層別化することが可能となる。本研究で実施している手法は膵癌における治療戦略の発展ならびに病態解明に寄与できる可能性があり，継続的な研究実行を行う予定である。