743 - What PET/CT Reveals After Transarterial Microperfusion for Pancreatic Cancer

Monday, April 13, 2026

5:03 PM - 5:09 PM ET

Abstract Presenter(s)

AS

Armaan Shah, MD (he/him/his)

Resident Physician
Lenox Hill Hospital, United States

Author/Co-author(s)

GL

Gavin Luckey, BS

Medical Student
USF Health Morsani School of Medicine, United States
JH

Jonathan Henning, BS

Medical Student
University of South Florida Morsani College of Medicine, United States
RJ

Rahul Jain, BS

Medical Student
USF Health Morsani College of Medicine, United States
JK

Joe Khoury, DO, MBA, RPVI

Interventional Radiologist
Emory, United States
ES

Elias Salloum, MD

Physician
Moffitt Cancer Center, United States
Bela Kis, MD, PhD, FSIR (he/him/his)

Section Chief
Moffitt Cancer Center, United States
MA

Mustafa Al-Roubaie, MD

Interventional Radiologist
Moffitt Cancer Center, United States

Learning Objectives: • Review the rationale and technique for transarterial microperfusion (TAMP) of gemcitabine in Locally Advanced Pancreatic Cancer (LAPC).
• Illustrate clinical and metabolic response assessment using PET/CT.
• Discuss patient selection, outcomes, and key safety considerations.

Background: LAPC is associated with a poor prognosis and limited response to radiation and systemic chemotherapy, which is often accompanied by significant toxicity. Transarterial delivery of gemcitabine aims to maximize local drug concentration while reducing systemic exposure. Recent phase II/III studies and pharmacokinetic analyses demonstrate that intra-arterial gemcitabine (IAG) via dual-balloon microcatheter achieves higher local drug delivery and reduced systemic toxicity compared to intravenous administration. Early data suggest improved disease control, especially in tumors of the pancreatic head and neck, and a higher 6-month overall survival rate with fewer adverse events compared to intravenous regimens.

Clinical Findings/Procedure Details: We present two patients with unresectable LAPC who underwent TAMP of gemcitabine. Both had tumors in the pancreatic head/neck and were not candidates for surgery or standard chemoradiation. The RenovoRx double-balloon microcatheter was advanced to the tumor-supplying artery (usually common hepatic, splenic, or SMA). Both balloons are inflated to occlude the vessel, and gemcitabine (1000 mg/m² over 20 minutes) was infused, allowing percolation into the tumor microenvironment. Each patient received eight cycles of intra-arterial gemcitabine over a period of two months. PET/CT imaging before and after treatment demonstrated a marginal reduction in tumor size, however, with a dramatic reduction in FDG avidity.

Conclusion and/or Teaching Points: Transarterial microperfusion of gemcitabine is a promising modality for LAPC, offering enhanced local control with reduced systemic toxicity. In a randomized trial, the 6-month overall survival rate was 100% for intra-arterial therapy versus 83.7% for intravenous therapy (p=0.0173), with a disease control rate of 53.9% and a median overall survival of 9.9–12.9 months for head/neck tumors. Clinical benefit rates with transarterial infusion can reach 83.3%. PET/CT can be valuable for monitoring metabolic response, which may precede morphologic changes. Careful patient selection and multidisciplinary planning are crucial for optimizing outcomes and minimizing complications. Ongoing trials will further define the role of PET/CT to evaluate this technique in LAPC management.