{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:36:09Z","timestamp":1791909369659,"version":"4.3.4"},"reference-count":31,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"This work was supported by Seoul National University Hospital research fund","award":["No. 04-2023-2280"],"award-info":[{"award-number":["No. 04-2023-2280"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Acta Radiol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Radiological response of pancreatic ductal adenocarcinoma (PDAC) to neoadjuvant chemoradiation therapy (CRT) is challenging to assess.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate whether computed tomography (CT) and biological features can predict tumor regression grade (TRG), recurrence-free survival (RFS), and overall survival (OS) of patients who undergo surgery after CRT for PDAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>This retrospective study included 125 patients who underwent surgery after CRT for non-metastatic PDAC between January 2013 and March 2021. Two board-certified radiologists independently reviewed initial and post-CRT CT images and assessed the primary tumor extent and regional lymph node metastasis. Another board-certified radiologist quantitatively assessed the primary tumor on pre- and post-CRT diffusion-weighted and positron emission tomography images. Logistic regression and Cox regression analyses were performed to identify predictors of TRG 0\/1, RFS, and OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 44 (35.2%) patients had a TRG of 0\/1. The normalized post-CRT carbohydrate antigen (CA) 19\u20139 level (&lt;37 IU) (odds ratio [OR]\u2009=\u20093.69;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.024) and adjacent organ invasion on post-CRT CT images (OR\u2009=\u20090.24;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.042) were independent predictors of TRG 0\/1. During follow-up (mean\u2009=\u200933.6 months), 68 (54.4%) patients experienced tumor recurrence and 65 (52.0%) died. The normalized post-CRT CA 19-9 level (&lt;37 IU) (hazard ratio [HR]\u2009=\u20090.51;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.028) was a significant predictor of RFS, and size change (%) after CRT (HR\u2009=\u20090.24;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.044) was an independent predictor of OS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The normalized post-CRT CA 19-9 level and adjacent organ invasion on post-CRT CT images predicted TRG. The normalized post-CRT CA 19-9 level was associated with RFS, whereas size change was an independent predictor of OS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02841851261424497","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T10:15:46Z","timestamp":1773224146000},"page":"388-398","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Prediction of tumor regression grade and identification of prognostic factors using CT and biological features in patients with pancreatic cancer who underwent surgery after neoadjuvant therapy"],"prefix":"10.1177","volume":"67","author":[{"given":"Jeongin","family":"Yoo","sequence":"first","affiliation":[{"name":"Seoul National University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sae-Jin","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Radiology, G&E Alphadom Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haeryoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Seoul National University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Bun","family":"Lee","sequence":"additional","affiliation":[{"name":"Seoul National University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8090-7758","authenticated-orcid":false,"given":"Jung Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Seoul National University Hospital"},{"name":"Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea"},{"name":"Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2018171670"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-74067-z"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.5009\/gnl20312"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.14132914"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.212236"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40644-023-00565-8"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-019-02289-5"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2023.08.009"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2019.0862"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003049"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2019.06.012"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2018172331"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-025-02131-7."},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.17.18310"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-017-1343-9"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e31818166e6"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-010-1727-5"},{"key":"e_1_3_2_19_2","unstructured":"NCCN Guidelines Version 2.2025 Pancreatic adenocarcinoma. 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