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. 2022 Dec;32(12):8317-8325.
doi: 10.1007/s00330-022-08891-4. Epub 2022 Jun 27.

Quantitative analysis of enhanced CT in differentiating well-differentiated pancreatic neuroendocrine tumors and poorly differentiated neuroendocrine carcinomas

Hai-Yan Chen  1   2 , Yao Pan  3 , Jie-Yu Chen  1   2 , Lu-Lu Liu  1   2 , Yong-Bo Yang  1   2 , Kai Li  1   2 , Ri-Sheng Yu  4 , Guo-Liang Shao  5   6   7
Affiliations

Quantitative analysis of enhanced CT in differentiating well-differentiated pancreatic neuroendocrine tumors and poorly differentiated neuroendocrine carcinomas

Hai-Yan Chen et al. Eur Radiol. 2022 Dec.

Abstract

Objective: To identify quantitative CT features for distinguishing well-differentiated pancreatic neuroendocrine tumors (PNETs) from poorly differentiated pancreatic neuroendocrine carcinomas (PNECs).

Materials and methods: Seventeen patients with PNECs and 131 patients with PNETs confirmed by biopsy or surgery were retrospectively included. General demographic (sex, age) and CT quantitative parameters (arterial/portal absolute enhancement, arterial/portal relative enhancement ratio, arterial/portal enhancement ratio) were collected. Univariate and multivariate logistic regression analyses were performed to confirm independent variables for differentiating PNECs from PNETs. Receiver operating characteristic (ROC) curves for each quantitative parameter were generated to determine their diagnostic ability.

Results: PNECs had a much lower mean arterial/portal absolute enhancement value (19.5 ± 11.0 vs. 78.8 ± 47.2; 28.1 ± 15.8 vs. 77.0 ± 39.4), arterial/portal relative enhancement ratio (0.57 ± 0.36 vs. 2.03 ± 1.31; 0.80 ± 0.52 vs. 1.99 ± 1.13), and arterial/portal enhancement ratio (0.62 ± 0.27 vs. 1.22 ± 0.49; 0.74 ± 0.19 vs. 1.21 ± 0.36) than PNETs (all p < 0.001). After multivariable analysis, arterial absolute enhancement (odds ratio [OR]: 0.96, 95% confidence interval [CI]: 0.93, 0.99) and portal absolute enhancement (OR: 0.96, 95% CI: 0.92, 0.99) were independent factors for differentiating PNECs from PNETs. For each quantitative parameter, arterial lesion enhancement yielded the highest diagnostic performance, with an area under the curve (AUC) of 0.922 (95% CI: 0.867-0.960), followed by portal absolute enhancement.

Conclusions: Arterial/portal absolute enhancements were independent predictors with good diagnostic accuracy for differentiating between PNETs and PNECs. Quantitative parameters of enhanced CT can distinguish PNECs from PNETs.

Key points: • PNECs were hypovascular and had a much lower enhanced CT attenuation in both arterial and portal phases than well-differentiated PNETs. • Quantitative parameters derived from enhanced CT can be used to distinguish PNECs from PNETs. • Arterial absolute enhancement and portal absolute enhancement were independent predictive factors for differentiating between PNETs and PNECs.

Keywords: Computed tomography; Neuroendocrine carcinoma; Neuroendocrine tumors; Pancreas.

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References

    1. Ma ZY, Gong YF, Zhuang HK et al (2020) Pancreatic neuroendocrine tumors: a review of serum biomarkers, staging, and management. World J Gastroenterol 26:2305–2322 - DOI - PubMed - PMC
    1. Cives M, Strosberg JR (2018) Gastroenteropancreatic neuroendocrine tumors. CA Cancer J Clin 68:471–487 - DOI - PubMed
    1. Choe J, Kim KW, Kim HJ et al (2019) What is new in the 2017 World Health Organization classification and 8th American Joint Committee on Cancer Staging System for pancreatic neuroendocrine neoplasms? Korean J Radiol 20:5–17 - DOI - PubMed
    1. Bosman F, Carneiro F, Hruban RH, Theise ND (2010) World Health Organization classification of tumours of the digestive system. IARC Press, Lyon, France, pp 13–14
    1. Perren A, Couvelard A, Scoazec JY et al (2017) ENETS consensus guidelines for the standards of care in neuroendocrine tumors: pathology: diagnosis and prognostic stratification. Neuroendocrinology 105:196–200 - DOI - PubMed

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