GASTROINTESTINAL AND ABDOMINAL RADIOLOGY / ORIGINAL PAPER
Computed tomography features in prediction of histological differentiation of pancreatic neuroendocrine neoplasms – a single-centre retrospective cohort study
1
Students’ Scientific Society, Department of Radiology & Nuclear Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
2
Department of Digestive Tract Surgery, Medical University of Silesia, Katowice, Poland
3
Department of Radiology & Nuclear Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
Submission date: 2024-04-21
Final revision date: 2024-06-24
Acceptance date: 2024-07-31
Publication date: 2024-09-30
Corresponding author
Jan Krzysztof Herzyk
Students’ Scientific Society, Department of Radiology & Nuclear Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland, e-mail: s76420@365.sum.edu.pl
Students’ Scientific Society, Department of Radiology & Nuclear Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland, e-mail: s76420@365.sum.edu.pl
Pol J Radiol, 2024; 89: 457-463
KEYWORDS
TOPICS
ABSTRACT
Purpose:
The aim of our study was to analyse the histological differentiation and computed tomography imaging features of pancreatic neuroendocrine neoplasms (PNENs).
Material and methods:
We performed a retrospective single-centre cohort study of 157 patients with histologically confirmed PNEN. We compared the results of the preoperative biopsy from the tumour with reports of the multi-slice computed tomography performed by a radiologist with 30 years of clinical practice.
Results:
Specific computed tomography (CT) features are associated with histological differentiation, such as enhancement in the arterial phase (p = 0.032), Wirsung’s duct dilatation (p = 0.001), other organ infiltration (p < 0.001), distant metastases (p < 0.001), and enlarged regional lymph nodes (p = 0.018). When there is an organ infiltration, the likelihood of the tumour having histological malignancy grades G2 or G3 triples (95% CI: 1.21-8.06). Likewise, the existence of distant metastases increases the risk almost fourfold (95% CI: 1.44-10.61), and a tumour size of 2 cm or larger is linked to a nearly threefold rise in the risk of histological malignancy grades G2 or G3 (95% CI: 1.21-6.24).
Conclusions:
Certain CT characteristics: enhancement during the arterial phase, Wirsung’s duct dilatation, organ infiltration, distant metastases, and the enlargement of regional lymph nodes are linked to histological differentiation.
The aim of our study was to analyse the histological differentiation and computed tomography imaging features of pancreatic neuroendocrine neoplasms (PNENs).
Material and methods:
We performed a retrospective single-centre cohort study of 157 patients with histologically confirmed PNEN. We compared the results of the preoperative biopsy from the tumour with reports of the multi-slice computed tomography performed by a radiologist with 30 years of clinical practice.
Results:
Specific computed tomography (CT) features are associated with histological differentiation, such as enhancement in the arterial phase (p = 0.032), Wirsung’s duct dilatation (p = 0.001), other organ infiltration (p < 0.001), distant metastases (p < 0.001), and enlarged regional lymph nodes (p = 0.018). When there is an organ infiltration, the likelihood of the tumour having histological malignancy grades G2 or G3 triples (95% CI: 1.21-8.06). Likewise, the existence of distant metastases increases the risk almost fourfold (95% CI: 1.44-10.61), and a tumour size of 2 cm or larger is linked to a nearly threefold rise in the risk of histological malignancy grades G2 or G3 (95% CI: 1.21-6.24).
Conclusions:
Certain CT characteristics: enhancement during the arterial phase, Wirsung’s duct dilatation, organ infiltration, distant metastases, and the enlargement of regional lymph nodes are linked to histological differentiation.
REFERENCES (32)
1.
Dasari A, Shen C, Halperin D, Zhao B, Zhou S, Xu Y, et al. Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol 2017; 3: 1335-1342.
2.
Krampitz GW, Norton JA. Pancreatic neuroendocrine tumors. Curr Probl Surg 2013; 50: 509-545.
3.
Kos-Kudła B, Blicharz-Dorniak J, Strzelczyk J, Bałdys-Waligórska A, Bednarczuk T, Bolanowski M, et al. Diagnostic and therapeutic guidelines for gastro-entero-pancreatic neuroendocrine neoplasms (recommended by the Polish Network of Neuroendocrine Tumours). Endokrynol Pol 2017; 68: 79-110.
4.
Shamim SA, Kumar A, Kumar R. PET/computed tomography in neuroendocrine tumor: value to patient management and survival outcomes. PET Clin 2015; 10: 411-421.
5.
Kos-Kudła B, Rosiek V, Borowska M, Bałdys-Waligórska A, Bednarczuk T, Blicharz-Dorniak J, et al. Pancreatic neuroendocrine neoplasms – management guidelines (recommended by the Polish Network of Neuroendocrine Tumours). Endokrynol Pol 2017; 68: 169-197.
6.
Bergsland EK, Woltering EA, Rindi G, O’Dorisio TM, Schilsky RL, Liu EH, et al. Neuroendocrine tumors of the pancreas. In: American Joint Committee on Cancer 2017. Amin MB, et al. (ed.). AJCC Cancer Staging Manual. Eight Edition. Cham: Springer; 2017, pp. 407-419.
7.
Klöppel G, Anlauf M. Epidemiology, tumour biology and histopathological classification of neuroendocrine tumours of the gastrointestinal tract. Best Pract Res Clin Gastroenterol 2005; 19: 507-517.
8.
Toste PA, Kadera BE, Tatishchev SF, Tatishchev SF, Dawson DW, Clerkin BM, et al. Nonfunctional pancreatic neuroendocrine tumors <2 cm on preoperative imaging are associated with a low incidence of nodal metastasis and an excellent overall survival. J Gastrointest Surg 2013; 17: 2105-2113.
9.
Ekeblad S, Skogseid B, Dunder K, Oberg K, Eriksson B. Prognostic factors and survival in 324 patients with pancreatic endocrine tumor treated at a single institution. Clin Cancer Res 2008; 14: 7798-7803.
10.
Fang JM, Shi J. A clinicopathologic and molecular update of pancreatic neuroendocrine neoplasms with a focus on the new World Health Organization classification. Arch Pathol Lab Med 2019; 143: 1317-1326.
11.
Beane JD, Borrebach JD, Billderback A, Onuma AE, Adam MA, Zureikat AH, et al. Small pancreatic neuroendocrine tumors: resect or enucleate? Am J Surg 2021; 222: 29-34.
12.
Rindi G, Klimstra DS, Abedi-Ardekani B, Asa SL, Bosman FT, Brambilla E, et al. A common classification framework for neuroendocrine neoplasms: an International Agency for Research on Cancer (IARC) and World Health Organization (WHO) expert consensus proposal. Mod Pathol 2018; 31: 1770-1786.
13.
Ma ZY, Gong YF, Zhuang HK, Zhou ZX, Huang SZ, Zou YP, et al. Pancreatic neuroendocrine tumors: a review of serum biomarkers, staging, and management. World J Gastroenterol 2020; 26: 2305-2322.
14.
Nagtegaal ID, Odze RD, Klimstra D, Paradis V, Rugge M, Schirmacher P, et al. The 2019 WHO classification of tumours of the digestive system. Histopathology 2020; 76.
15.
Scott AT, Howe JR. Evaluation and management of neuroendocrine tumors of the pancreas. Surg Clin North Am 2019; 99: 793-814.
16.
Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y, et al. Diagnosis and management of insulinoma. World J Gastroenterol 2013; 19: 829-837.
17.
Li D, Rock A, Kessler J, Ballena R, Hyder S, Mo C, et al. Understanding the management and treatment of well-differentiated pancreatic neuroendocrine tumors: a clinician’s guide to a complex illness. JCO Oncol Pract 2020; 16: 720-728.
18.
Dąbkowski K, Kos-Kudła B, Andrysiak-Mamos E, Syrenicz A, Pilch-Kowalczyk J, Starzyńska T. Cystic pancreatic neuroendocrine tumours – a gastroenterologist’s point of view. Endokrynol Pol 2018; 69: 320-325.
19.
Choi TW, Kim JH, Yu MH, Park SJ, Han JK. Pancreatic neuroendocrine tumor: prediction of the tumor grade using CT findings and computerized texture analysis. Acta Radiol 2018; 59: 383-392.
20.
Guo C, Zhuge X, Wang Z, Wang Q, Sun K, Feng Z, et al. Textural analysis on contrast-enhanced CT in pancreatic neuroendocrine neoplasms: association with WHO grade. Abdom Radiol (NY) 2019; 44: 576-585.
21.
Canellas R, Burk KS, Parakh A, Sahani DV. Prediction of pancreatic neuroendocrine tumor grade based on CT features and texture analysis. AJR Am J Roentgenol 2018; 210: 341-346.
22.
Dong Y, Yang DH, Tian XF, Lou WH, Wang HZ, Chen S, et al. Pancreatic neuroendocrine tumor: prediction of tumor grades by radiomics models based on ultrasound images. Br J Radiol 2023; 96: 20220783. DOI: 10.1259/bjr.20220783.
23.
Canellas R, Lo G, Bhowmik S, Ferrone C, Sahani D. Pancreatic neuroendocrine tumor: correlations between MRI features, tumor biology, and clinical outcome after surgery. J Magn Reson Imaging 2018; 47: 425-432.
24.
Guo CG, Ren S, Chen X, Wang QD, Xiao WB, Zhang JF, et al. Pancreatic neuroendocrine tumor: prediction of the tumor grade using magnetic resonance imaging findings and texture analysis with 3-T magnetic resonance. Cancer Manag Res 2019; 11: 1933-1944.
25.
Vasilescu AM, Andriesi Rusu DF, Bradea C, Vlad N, Lupascu-Ursulescu C, Cianga Spiridon IA, et al. Protective or risk factors for postoperative pancreatic fistulas in malignant pathology. Life (Basel) 2021; 11: 1216. DOI: 10.3390/life11111216.
26.
Zhou B, Zhan C, Xiang J, Ding Y, Yan S. Clinical significance of the preoperative main pancreatic duct dilation and neutrophil-to-lymphocyte ratio in pancreatic neuroendocrine tumors (PNETs) of the head after curative resection. BMC Endocr Disord 2019; 19: 123. DOI: 10.1186/s12902-019-0454-4.
27.
Radu EC, Saizu AI, Grigorescu RR, Croitoru AE, Gheorghe C. Metastatic neuroendocrine pancreatic tumor – case report. J Med Life 2018; 11: 57-61.
28.
Rossi RE, Massironi S, Conte D, Peracchi M. Therapy for metastatic pancreatic neuroendocrine tumors. Ann Transl Med 2014; 2: 8. DOI: 10.3978/j.issn.2305-5839.2013.03.01.
29.
Yano M, Shetty AS, Williams GA, Lancia S, Trikalinos NA, Ham-mill CW, et al. Qualitative imaging features of pancreatic neuroendocrine neoplasms predict histopathologic characteristics including tumor grade and patient outcome. Abdom Radiol (NY) 2022; 47: 3971-3985.
30.
Pezzilli R, Partelli S, Cannizzaro R, Pagano N, Crippa S, Pagnanelli M, Falconi M. Ki-67 prognostic and therapeutic decision driven marker for pancreatic neuroendocrine neoplasms (PNENs): a systematic review. Adv Med Sci 2016; 61: 147-153.
31.
Yu H, Li M, Cao D, Wang Y, Zeng N, Cheng Y, et al. Enhanced computed tomography features predict pancreatic neuroendocrine neoplasm with Ki-67 index less than 5%. Eur J Radiol 2022; 147: 110100. DOI: https://doi.org/10.1016/j.ejra....
32.
Tatsumoto S, Kodama Y, Sakurai Y, Shinohara T, Katanuma A, Maguchi H. Pancreatic neuroendocrine neoplasm: correlation between computed tomography enhancement patterns and prognostic factors of surgical and endoscopic ultrasound-guided fine-needle aspiration biopsy specimens. Abdom Imaging 2013; 38: 358-366.
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