Background: Multiple studies have shown that obesity is associated with an increased incidence and aggressiveness of pancreatic cancer. The precise role that pancreatic fat plays in this process remains under investigation. We tested the hypothesis that pancreatic steatosis is associated with increased dissemination and reduced survival in patients with pancreatic cancer using non-invasive magnetic resonance imaging (MRI) quantification.
Methods: We conducted a prospective study of patients with pancreatic tumor, where each patient had both abdominal MR scan and free DNA sample at the time of diagnosis, as well as available clinical and laboratory parameters. Based on DIXON Quant scan we calculated the percentage of fat in the non-tumor pancreatic parenchyma and liver parenchyma.
Results: We investigated 31 patients with pancreatic tumor, (female=15), mean age 68.5 years, with average fatty infiltration quantities as high as 13.3 %, compared to 5.7 % in the control group (p < .001) who had abdominal MRI scan due to any other reason apart from cancer and with the same imaging protocol. The two groups were matched by age and gender. There was no significant difference in the presence of fatty liver and increased BMI between two groups (p>0.05). Free DNA level in study cohort was 1564.8 vs 800 considered normal.
Conclusion: Several studies have shown previously the correlation between pancreatic steatosis and ductal pancreatic carcinoma, based on the pathological evaluation of surgical specimens. In our study, there was a positive correlation between FI in the pancreas and pancreatic cancer. We present a modern imaging protocol, which may serve as a prognostic, non-invasive test as part of the routine work-up to predict the disease course and aggressiveness of the tumor.
