Pancreatic neuroendocrine neoplasms: Magnetic resonance imaging features according to grade and stage.

Abstract

AIM:

To describe magnetic resonance (MR) imaging features of pancreatic neuroendocrine neoplasms (PanNENs) according to their grade and tumor-nodes-metastases stage by comparing them to histopathology and to determine the accuracy of MR imaging features in predicting their biological behavior.

METHODS:

This study was approved by our institutional review board; requirement for informed patient consent was waived due to the retrospective nature of the study. Preoperative MR examinations of 55 PanNEN patients (29 men, 26 women; mean age of 57.6 years, range 21-83 years) performed between June 2013 and December 2015 were reviewed. Qualitative and quantitative features were compared between tumor grades and stages determined by histopathological analysis.

RESULTS:

Ill defined margins were more common in G2-3 and stage III-IV PanNENs than in G1 and low-stage tumors (P < 0.001); this feature had high specificity in the identification of G2-3 and stage III-IV tumors (90.3% and 96%, 95%CI: 73.1-97.5 and 77.7-99.8). The mean apparent diffusion coefficient value was significantly lower in G2-3 and stage III-IV lesions compared to well differentiated and low-stage tumors (1.09 × 10-3 mm2/s vs 1.45 × 10-3 mm2/s and 1.10 × 10-3 mm2/s vs 1.53 × 10-3 mm2/s, P = 0.003 and 0.001). Receiving operator characteristic analysis determined optimal cut-offs of 1.21 and 1.28 × 10-3 mm2/s for the identification of G2-3 and stage III-IV tumors, with sensitivity and specificity values of 70.8/80.7% and 64.5/64% (95%CI: 48.7-86.6/60-92.7 and 45.4-80.2/42.6-81.3).

CONCLUSION:

MR features of PanNENs vary according to their grade of differentiation and their stage at diagnosis and could predict the biological behavior of these tumors.

• Authors: Riccardo De Robertis, Sara Cingarlini, Paolo Tinazzi Martini, Silvia Ortolani, Giovanni Butturini, Luca Landoni, Paolo Regi, Roberto Girelli, Paola Capelli, Stefano Gobbo, Giampaolo Tortora, Aldo Scarpa, Paolo Pederzoli, Mirko D'Onofrio
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 23 Issue 2 Pg. 275-285 (Jan 14 2017) ISSN: 2219-2840 [Electronic] United States
• PMID: 28127201 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Contrast Media
• Organometallic Compounds
• gadobenic acid
• Meglumine

Topics

• Adult
• Aged
• Aged, 80 and over
• Contrast Media (administration & dosage)
• Diffusion Magnetic Resonance Imaging
• Female
• Humans
• Image Interpretation, Computer-Assisted
• Male
• Meglumine (administration & dosage, analogs & derivatives)
• Middle Aged
• Neoplasm Grading
• Neoplasm Staging
• Neuroendocrine Tumors (diagnostic imaging, pathology)
• Organometallic Compounds (administration & dosage)
• Pancreatic Neoplasms (diagnostic imaging, pathology)
• Preoperative Care (methods)
• ROC Curve
• Reproducibility of Results
• Retrospective Studies
• Sensitivity and Specificity
• Young Adult