Morphological imaging and CT histogram analysis to differentiate pancreatic neuroendocrine tumor grade 3 from neuroendocrine carcinoma - 26/11/20
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Highlights |
• | Pancreatic neuroendocrine carcinomas are larger and more necrotic than G3-neuroendocrine tumors. |
• | Neuroendocrine carcinomas show lower attenuation than G3- neuroendocrinetumors. |
• | On MRI, neuroendocrine carcinomas may contain hemorrhagic content and havelower ADC values than G3- neuroendocrine tumors. |
• | With CT histogram analysis, neuroendocrine carcinomas are more heterogeneous than G3- neuroendocrine tumors. |
Abstract |
Purpose |
To compare morphological imaging features and CT texture histogram parameters between grade 3 pancreatic neuroendocrine tumors (G3-NET) and neuroendocrine carcinomas (NEC).
Materials and methods |
Patients with pathologically proven G3-NET and NEC, according to the 2017 World Health Organization classification who had CT and MRI examinations between 2006-2017 were retrospectively included. CT and MRI examinations were reviewed by two radiologists in consensus and analyzed with respect to tumor size, enhancement patterns, hemorrhagic content, liver metastases and lymphadenopathies. Texture histogram analysis of tumors was performed on arterial and portal phase CT images. images. Morphological imaging features and CT texture histogram parameters of G3-NETs and NECs were compared.
Results |
Thirty-seven patients (21 men, 16 women; mean age, 56±13 [SD] years [range: 28-82 years]) with 37 tumors (mean diameter, 60±46 [SD] mm) were included (CT available for all, MRI for 16/37, 43%). Twenty-three patients (23/37; 62%) had NEC and 14 patients (14/37; 38%) had G3-NET. NECs were larger than G3-NETs (mean, 70±51 [SD] mm [range: 18 - 196mm] vs. 42±24 [SD] mm [range: 8 - 94mm], respectively; P=0.039), with more tumor necrosis (75% vs. 33%, respectively; P=0.030) and lower attenuation on precontrast (30±4 [SD] HU [range: 25-39 HU] vs. 37±6 [SD] [range: 25-45 HU], respectively; P=0.002) and on portal venous phase CT images (75±18 [SD] HU [range: 43 - 108 HU] vs. 92±19 [SD] HU [range: 46 - 117 HU], respectively; P=0.014). Hemorrhagic content on MRI was only observed in NEC (P=0.007). The mean ADC value was lower in NEC ([1.1±0.1 (SD)]×10−3 mm2/s [range: (0.91 - 1.3)×10−3 mm2/s] vs. [1.4±0.2 (SD)]×10−3 mm2/s [range: (1.1 - 1.6)×10−3 mm2/s]; P=0.005). CT histogram analysis showed that NEC were more heterogeneous on portal venous phase images (Entropy-0: 4.7±0.2 [SD] [range: 4.2-5.1] vs. 4.5±0.4 [SD] [range: 3.7-4.9]; P=0.023).
Conclusion |
Pancreatic NECs are larger, more frequently hypoattenuating and more heterogeneous with hemorrhagic content than G3-NET on CT and MRI.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Neuroendocrine tumors, OMS 2017, Tomography, X-ray computed, Magnetic resonance imaging, Texture analysis
Abbreviations : 3D, ADC, AUC, CT, DWI, ENETS, Ent, G2/G3, HU, Kurt, MiNEN, MPP, MRI, PACS, NET/NEC, NEN, ROC, ROI, SD, SNFGE, Ske, WHO
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Vol 101 - N° 12
P. 821-830 - dicembre 2020 Ritorno al numero
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