ReviewsAdvances in Diagnostic and Intraoperative Molecular Imaging of Pancreatic CancerTummers, Willemieke S. MD*†; Willmann, Juergen K. MD*✝; Bonsing, Bert A. MD, PhD†; Vahrmeijer, Alexander L. MD, PhD†; Gambhir, Sanjiv S. MD, PhD*‡§; Swijnenburg, Rutger-Jan MD, PhD†Author Information From the *Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, Stanford, CA; †Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands; and ‡Department of Bioengineering, and §Department of Materials Science and Engineering, Molecular Imaging Program at Stanford, Canary Center at Stanford for Cancer Early Detection, Stanford University, Stanford, CA. Received for publication September 25, 2017; accepted April 16, 2018. Address correspondence to: Rutger-Jan Swijnenburg, MD, PhD, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands (e-mail: [email protected]). This work was supported in part by NIH R21EB022770 and NIH R41CA203090 (both to JKW). The contribution of Willemieke S. Tummers to this work was supported in part by Michaël-van Vloten Fonds. The authors declare no conflict of interest. This manuscript describes the investigational use of cetuximab-IRDye800, SGM-101, and [18F]FP-R01-MG-F2, where are not yet approved by the Food and Drug Administration. (✝)-Juergen K. Willmann died January 8, 2018. Pancreas: July 2018 - Volume 47 - Issue 6 - p 675-689 doi: 10.1097/MPA.0000000000001075 Buy Metrics Abstract Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis. To improve outcomes, there is a critical need for improved tools for detection, accurate staging, and resectability assessment. This could improve patient stratification for the most optimal primary treatment modality. Molecular imaging, used in combination with tumor-specific imaging agents, can improve established imaging methods for PDAC. These novel, tumor-specific imaging agents developed to target specific biomarkers have the potential to specifically differentiate between malignant and benign diseases, such as pancreatitis. When these agents are coupled to various types of labels, this type of molecular imaging can provide integrated diagnostic, noninvasive imaging of PDAC as well as image-guided pancreatic surgery. This review provides a detailed overview of the current clinical imaging applications, upcoming molecular imaging strategies for PDAC, and potential targets for imaging, with an emphasis on intraoperative imaging applications. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.