• ISSN 1674-8301
  • CN 32-1810/R
Volume 35 Issue 3
May  2021
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Article Contents
Xu Wenbin, Yan Han, Xu Lulu, Li Mingna, Gao Wentao, Jiang Kuirong, Wu Junli, Miao Yi. Correlation between radiologic features on contrast-enhanced CT and pathological tumor grades in pancreatic neuroendocrine neoplasms[J]. The Journal of Biomedical Research, 2021, 35(3): 179-188. doi: 10.7555/JBR.34.20200039
Citation: Xu Wenbin, Yan Han, Xu Lulu, Li Mingna, Gao Wentao, Jiang Kuirong, Wu Junli, Miao Yi. Correlation between radiologic features on contrast-enhanced CT and pathological tumor grades in pancreatic neuroendocrine neoplasms[J]. The Journal of Biomedical Research, 2021, 35(3): 179-188. doi: 10.7555/JBR.34.20200039

Correlation between radiologic features on contrast-enhanced CT and pathological tumor grades in pancreatic neuroendocrine neoplasms

doi: 10.7555/JBR.34.20200039
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  • Corresponding author: Yi Miao, Pancreas Center, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China. Tel: +86-25-6830-6590, E-mail: miaoyi@njmu.edu.cn
  • Received: 2020-03-18
  • Revised: 2020-06-14
  • Accepted: 2020-06-19
  • Published: 2020-08-21
  • Issue Date: 2021-05-28
  • Contrast-enhanced computed tomography (CT) contributes to the increasing detection of pancreatic neuroendocrine neoplasms (PNENs). Nevertheless, its value for differentiating pathological tumor grades is not well recognized. In this report, we have conducted a retrospective study on the relationship between the 2017 World Health Organization (WHO) classification and CT imaging features in 94 patients. Most of the investigated features eventually provided statistically significant indicators for discerning PNENs G3 from PNENs G1/G2, including tumor size, shape, margin, heterogeneity, intratumoral blood vessels, vascular invasion, enhancement pattern in both contrast phases, enhancement degree in both phases, tumor-to-pancreas contrast ratio in both phases, common bile duct dilatation, lymph node metastases, and liver metastases. Ill-defined tumor margin was an independent predictor for PNENs G3 with the highest area under the curve (AUC) of 0.906 in the multivariable logistic regression and receiver operating characteristic curve analysis. The portal enhancement ratio (PER) was shown the highest AUC of 0.855 in terms of quantitative features. Our data suggest that the traditional contrast-enhanced CT still plays a vital role in differentiation of tumor grades and heterogeneity analysis prior to treatment.


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  • [1]
    Yao JC, Hassan M, Phan A, et al. One hundred years after "carcinoid": epidemiology of and prognostic factors for neuroendocrine tumors in 35, 825 cases in the United States[J]. J Clin Oncol, 2008, 26(18): 3063–3072. doi: 10.1200/JCO.2007.15.4377
    Reid MD, Balci S, Saka B, et al. Neuroendocrine tumors of the pancreas: current concepts and controversies[J]. Endocr Pathol, 2014, 25(1): 65–79. doi: 10.1007/s12022-013-9295-2
    Ricci C, Casadei R, Taffurelli G, et al. WHO 2010 classification of pancreatic endocrine tumors. is the new always better than the old?[J]. Pancreatology, 2014, 14(6): 539–541. doi: 10.1016/j.pan.2014.09.005
    Inzani F, Petrone G, Rindi G. The new world health organization classification for pancreatic Neuroendocrine Neoplasia[J]. Endocrinol Metab Clin North Am, 2018, 47(3): 463–470. doi: 10.1016/j.ecl.2018.04.008
    Kim JH, Eun HW, Kim YJ, et al. Pancreatic neuroendocrine tumour (PNET): Staging accuracy of MDCT and its diagnostic performance for the differentiation of PNET with uncommon CT findings from pancreatic adenocarcinoma[J]. Eur Radiol, 2016, 26(5): 1338–1347. doi: 10.1007/s00330-015-3941-7
    Guo CG, Zhuge XL, Wang ZQ, et al. Textural analysis on contrast-enhanced CT in pancreatic neuroendocrine neoplasms: association with WHO grade[J]. Abdom Radiol, 2019, 44(2): 576–585. doi: 10.1007/s00261-018-1763-1
    Kang J, Ryu JK, Son JH, et al. Association between pathologic grade and multiphase computed tomography enhancement in pancreatic neuroendocrine neoplasm[J]. J Gastroenterol Hepatol, 2018, 33(9): 1677–1682. doi: 10.1111/jgh.14139
    Kulali F, Semiz-Oysu A, Demir M, et al. Role of diffusion-weighted MR imaging in predicting the grade of nonfunctional pancreatic neuroendocrine tumors[J]. Diagn Interv Imaging, 2018, 99(5): 301–309. doi: 10.1016/j.diii.2017.10.012
    Okabe H, Hashimoto D, Chikamoto A, et al. Shape and enhancement characteristics of pancreatic neuroendocrine tumor on preoperative contrast-enhanced computed tomography may be prognostic indicators[J]. Ann Surg Oncol, 2017, 24(5): 1399–1405. doi: 10.1245/s10434-016-5630-4
    Toshima F, Inoue D, Komori T, et al. Is the combination of MR and CT findings useful in determining the tumor grade of pancreatic neuroendocrine tumors?[J]. Jpn J Radiol, 2017, 35(5): 242–253. doi: 10.1007/s11604-017-0627-x
    Belousova E, Karmazanovsky G, Kriger A, et al. Contrast-enhanced MDCT in patients with pancreatic neuroendocrine tumours: correlation with histological findings and diagnostic performance in differentiation between tumour grades[J]. Clin Radiol, 2017, 72(2): 150–158. doi: 10.1016/j.crad.2016.10.021
    Kim DW, Kim HJ, Kim KW, et al. Neuroendocrine neoplasms of the pancreas at dynamic enhanced CT: comparison between grade 3 neuroendocrine carcinoma and grade 1/2 neuroendocrine tumour[J]. Eur Radiol, 2015, 25(5): 1375–1383. doi: 10.1007/s00330-014-3532-z
    Takumi K, Fukukura Y, Higashi M, et al. Pancreatic neuroendocrine tumors: Correlation between the contrast-enhanced computed tomography features and the pathological tumor grade[J]. Eur J Radiol, 2015, 84(8): 1436–1443. doi: 10.1016/j.ejrad.2015.05.005
    Luo YJ, Dong Z, Chen J, et al. Pancreatic neuroendocrine tumours: correlation between MSCT features and pathological classification[J]. Eur Radiol, 2014, 24(11): 2945–2952. doi: 10.1007/s00330-014-3317-4
    Cappelli C, Boggi U, Mazzeo S, et al. Contrast enhancement pattern on multidetector CT predicts malignancy in pancreatic endocrine tumours[J]. Eur Radiol, 2015, 25(3): 751–759. doi: 10.1007/s00330-014-3485-2
    Canellas R, Burk KS, Parakh A, et al. Prediction of pancreatic neuroendocrine tumor grade based on CT features and texture analysis[J]. AJR Am J Roentgenol, 2018, 210(2): 341–346. doi: 10.2214/AJR.17.18417
    D'Onofrio M, Ciaravino V, Cardobi N, et al. CT enhancement and 3D texture analysis of pancreatic neuroendocrine neoplasms[J]. Sci Rep, 2019, 9(1): 2176. doi: 10.1038/s41598-018-38459-6
    Horiguchi S, Kato H, Shiraha H, et al. Dynamic computed tomography is useful for prediction of pathological grade in pancreatic neuroendocrine neoplasm[J]. J Gastroenterol Hepatol, 2017, 32(4): 925–931. doi: 10.1111/jgh.13594
    Bergers G, Benjamin LE. Tumorigenesis and the angiogenic switch[J]. Nat Rev Cancer, 2003, 3(6): 401–410. doi: 10.1038/nrc1093
    Ellis LM, Takahashi Y, Fenoglio CJ, et al. Vessel counts and vascular endothelial growth factor expression in pancreatic adenocarcinoma[J]. Eur J Cancer, 1998, 34(3): 337–340. doi: 10.1016/S0959-8049(97)10068-5
    Duarte IG, Bufkin BL, Pennington MF, et al. Angiogenesis as a predictor of survival after surgical resection for stage I non-small-cell lung cancer[J]. J Thorac Cardiovasc Surg, 1998, 115(3): 652–659. doi: 10.1016/S0022-5223(98)70331-9
    Weidner N, Folkman J, Pozza F, et al. Tumor angiogenesis: a new significant and independent prognostic indicator in early-stage breast carcinoma[J]. J Natl Cancer Inst, 1992, 84(24): 1875–1887. doi: 10.1093/jnci/84.24.1875
    Vermeulen PB, Verhoeven D, Hubens G, et al. Microvessel density, endothelial cell proliferation and tumour cell proliferation in human colorectal adenocarcinomas[J]. Ann Oncol, 1995, 6(1): 59–64. doi: 10.1093/oxfordjournals.annonc.a059043
    Takahashi Y, Akishima-Fukasawa Y, Kobayashi N, et al. Prognostic value of tumor architecture, tumor-associated vascular characteristics, and expression of angiogenic molecules in pancreatic endocrine tumors[J]. Clin Cancer Res, 2007, 13(1): 187–196. doi: 10.1158/1078-0432.CCR-06-1408
    Marion-Audibert AM, Barel C, Gouysse G, et al. Low microvessel density is an unfavorable histoprognostic factor in pancreatic endocrine tumors[J]. Gastroenterology, 2003, 125(4): 1094–1104. doi: 10.1016/S0016-5085(03)01198-3
    d'Assignies G, Couvelard A, Bahrami S, et al. Pancreatic endocrine tumors: tumor blood flow assessed with perfusion CT reflects angiogenesis and correlates with prognostic factors[J]. Radiology, 2009, 250(2): 407–416. doi: 10.1148/radiol.2501080291
    Yamada S, Fujii T, Suzuki K, et al. Preoperative identification of a prognostic factor for pancreatic neuroendocrine tumors using multiphase contrast-enhanced computed tomography[J]. Pancreas, 2016, 45(2): 198–203. doi: 10.1097/MPA.0000000000000443
    Choi TW, Kim JH, Yu MH, et al. Pancreatic neuroendocrine tumor: prediction of the tumor grade using CT findings and computerized texture analysis[J]. Acta Radiol, 2018, 59(4): 383–392. doi: 10.1177/0284185117725367
    Basturk O, Yang ZH, Tang LH, et al. The high-grade (WHO G3) pancreatic neuroendocrine tumor category is morphologically and biologically heterogenous and includes both well differentiated and poorly differentiated neoplasms[J]. Am J Surg Pathol, 2015, 39(5): 683–690. doi: 10.1097/PAS.0000000000000408
    Singhi AD, Klimstra DS. Well-differentiated pancreatic neuroendocrine tumours (PanNETs) and poorly differentiated pancreatic neuroendocrine carcinomas (PanNECs): concepts, issues and a practical diagnostic approach to high-grade (G3) cases[J]. Histopathology, 2018, 72(1): 168–177. doi: 10.1111/his.13408
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