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After\n IRE<\/jats:styled-content>\n , mice received six intraperitoneal injections of anti\u2010\n PD<\/jats:styled-content>\n \u20101 over 2\u2009weeks.\n T2<\/jats:styled-content>\n \u2010weighted\n MRI<\/jats:styled-content>\n ,\n T1<\/jats:styled-content>\n \u2010weighted\n MRI<\/jats:styled-content>\n with macromolecular contrast agent poly(L\u2010glutamic acid)\u2010conjugated gadolinium (\n PG<\/jats:styled-content>\n \u2010Gd), and\n DWI<\/jats:styled-content>\n were performed before and after\n IRE<\/jats:styled-content>\n . Survival was analyzed using Kaplan\u2013Meier curves. Mice surviving at least 100\u2009days without recurrence after\n IRE<\/jats:styled-content>\n were considered complete responders. Relationships between\n MRI<\/jats:styled-content>\n findings and treatment response were assessed with one\u2010way\n ANOVA<\/jats:styled-content>\n , Student's\n t<\/jats:italic>\n \u2010test, and receiver operating characteristic (\n ROC<\/jats:styled-content>\n ) analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Tumor volume on\n T2<\/jats:styled-content>\n \u2010weighted\n MRI<\/jats:styled-content>\n at early treatment time\u2010points did not correlate with survival.\n T1<\/jats:styled-content>\n \u2010weighted\n MRI<\/jats:styled-content>\n with\n PG<\/jats:styled-content>\n \u2010Gd clearly showed increased\n PG<\/jats:styled-content>\n \u2010Gd uptake in tumors on days 4 and 11\u201314 after\n IRE<\/jats:styled-content>\n and anti\u2010\n PD<\/jats:styled-content>\n \u20101 immunotherapy. Higher\n PG<\/jats:styled-content>\n \u2010Gd uptake correlated with longer survival (\n \n R\n 2<\/jats:sup>\n <\/jats:styled-content>\n \u2009=\u20090.634;\n p<\/jats:italic>\n \u2009<\u20090.0001). Area\u2010under\u2010the\u2010\n ROC<\/jats:styled-content>\n curve had high predictive value for treatment outcome (0.805;\n p<\/jats:italic>\n \u2009=\u20090.033). Immunofluorescence staining confirmed high accumulation of macrophages in tumors after treatment. On\n DWI<\/jats:styled-content>\n , all\n KRAS<\/jats:styled-content>\n * tumors exhibited significantly increased apparent diffusion coefficient (\n ADC<\/jats:styled-content>\n ) values 7, 11, and 14\u2009days after combination therapy. Moreover, pretreatment tumor\n ADC<\/jats:styled-content>\n values were significantly higher in complete responders than in partial responders (\n p<\/jats:italic>\n \u2009=\u20090.0025).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n PG<\/jats:styled-content>\n \u2010Gd contrast\u2010enhanced\n T1<\/jats:styled-content>\n \u2010weighted\n MRI<\/jats:styled-content>\n and\n DWI<\/jats:styled-content>\n are potential predictors of response to combined\n IRE<\/jats:styled-content>\n and anti\u2010\n PD<\/jats:styled-content>\n \u20101 immunotherapy in\n PDAC<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mrm.70188","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T04:35:41Z","timestamp":1763699741000},"page":"2266-2276","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multiparametric\n MRI<\/scp>\n to Predict Response to Irreversible Electroporation Plus Anti\u2010\n PD<\/scp>\n \u20101 Immunotherapy in Pancreatic Ductal Adenocarcinoma"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8523-3468","authenticated-orcid":false,"given":"Qizhen","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Cancer Systems Imaging The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8109-3995","authenticated-orcid":false,"given":"Mark D.","family":"Pagel","sequence":"additional","affiliation":[{"name":"Department of Cancer Systems Imaging The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles V.","family":"Kingsley","sequence":"additional","affiliation":[{"name":"Department of Imaging Physics The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingfei","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Imaging Physics The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James P.","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Biostatistics The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoxia","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Cancer Systems Imaging The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seth T.","family":"Gammon","sequence":"additional","affiliation":[{"name":"Department of Cancer Systems Imaging The University of Texas MD Anderson Cancer Center Houston Texas 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