Incremental Value of Magnetic Resonance Imaging in Selection of Pancreatic Cancer Patients for Surgery

Incremental Value of Magnetic Resonance Imaging in Selection of Pancreatic Cancer Patients for Surgery (MAGIPAC): A Randomized Clinical Trial.

The aim of the study is to examine the incremental value of using magnetic resonance imaging (MRI) in addition to computed tomography (CT) in the diagnostic workup of pancreatic cancer patients.

The aim of the study is to examine the incremental value of using magnetic resonance imaging (MRI) in addition to computed tomography (CT) in the diagnostic workup of pancreatic cancer patients. We will conduct a nationwide, prospective clinical trial to examine the incremental value of using MRI for identification of liver metastases in pancreatic cancer patients.

Inclusion criteria:

• Pancreatic cancer patients considered to have a locally resectable or borderline resectable tumor by the local hepato-pancreato-biliary multidisciplinary team board
• No liver metastases on CT
• At least 18 years old and able to provide informed consent
• Expected pancreatic ductal adenocarcinoma based on CT scan

Exclusion criteria:

• Metastatic disease
• Prior receipt of neoadjuvant chemotherapy or downstaging/-sizing treatment
• Comorbidity rendering major surgery unfeasible (inoperable)
• No informed consent
• Unable to undergo MRI (Kidney insufficiency (eGFR < 60 ml/min/1.73 m2 body surface ar-ea); Claustrophobia; Cardiac pacemaker)
• Postoperative histology other than adenocarcinoma of pancreato-biliary origin.
• MRI with liver-specific contrast performed during standard workup.