Longitudinal imaging markers for pancreas cancer tumor response via Eshelby biomechanics Conference Paper


Authors: Heiselman, J. S.; Horvat, N.; El Homsi, M.; Ecker, B. L.; O'Reilly, E. M.; Kingham, T. P.; Soares, K. C.; D'Angelica, M. I.; Jarnagin, W. R.; Do, R. K. G.; Wei, A. C.; Chakraborty, J.
Title: Longitudinal imaging markers for pancreas cancer tumor response via Eshelby biomechanics
Conference Title: Medical Imaging 2025: Image-Guided Procedures, Robotic Interventions, and Modeling
Abstract: Purpose: Pancreatic ductal adenocarcinoma (PDAC) often presents with poorly defined lesions and low imaging contrast, which impedes accurate assessment of therapeutic response. Current non-invasive clinical markers are limited to RECIST and blood-based biomarkers CA19-9 and CEA, which are widely regarded to be insufficient descriptors of PDAC response to therapy. We propose a contrast-independent and modality-independent biomechanical image registration workflow for characterizing therapeutic response by leveraging the Eshelby inclusion problem to estimate the transformation strain of the tumor from whole pancreas segmentations across the treatment interval. Methods: An Eshelby inclusion model was constructed to parameterize pancreatic mass effect that arises due to transformation strain of the tumor. This model was integrated into a biomechanical image registration framework to simultaneously resolve changes in tumor and parenchymal shape between baseline and restaging imaging. In 25 patients with measured pathologic response to a standardized neoadjuvant chemotherapy regimen, Eshelby transformation strain was compared to RECIST v1.1 score and changes in serum CA19-9 and CEA as indicators for therapeutic response. Correlations between each variable and pathologic response were assessed using Spearman's ρ, and prognostic value towards stratifying pathologic response was evaluated via Wilcoxon rank sum tests at a significance level of α=0.05. Results: Tumor transformation strain was significantly associated with pathologic response (ρ=0.55, p=0.008), whereas the change in CA19-9 (ρ=0.29, p=0.19), RECIST score (ρ=0.09, p=0.71), and change in CEA (ρ=0.07, p=0.75) did not exhibit significant correlation. Current clinical markers for therapeutic response were not able to stratify pathologic response based on above- versus below-median values of each marker (RECIST: p=0.49; ΔCA19-9: p=0.24; ΔCEA: p=0.54), whereas the Eshelby transformation strain effectively distinguished patients who achieved more favorable pathologic response (p=0.009). Conclusions: The Eshelby biomechanical model of tumor transformation strain offers a modality- and intensity-independent mechanism for characterizing therapeutic response that surpasses current clinical markers for PDAC. © 2025 SPIE
Keywords: chemotherapy; pancreas; biomarker; response; image registration; biomechanics; eshelby; mass effect
Journal Title Progress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume: 13408
Conference Dates: 2025 Feb 17-20
Conference Location: San Deigo, CA
ISBN: 1605-7422
Publisher: SPIE  
Date Published: 2025-01-01
Start Page: 1340813
Language: English
DOI: 10.1117/12.3049031
PROVIDER: scopus
DOI/URL:
Notes: Conference paper (ISBN: 9781510685949) -- Source: Scopus
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MSK Authors
  1. William R Jarnagin
    903 Jarnagin
  2. Kinh Gian Do
    256 Do
  3. T Peter Kingham
    609 Kingham
  4. Eileen O'Reilly
    780 O'Reilly
  5. Alice Chia-Chi Wei
    197 Wei
  6. Kevin Cerqueira Soares
    135 Soares