Pancreatic neuroendocrine tumors (pNETs): the predictive value of MDCT characteristics in the differentiation of histopathological grades

Salahshour, Faeze; Mehrabinejad, Mohammad-Mehdi; Dehnavi, Ali Zare; Alibakhshi, Abbas; Dashti, Habibollah; Ataee, M; Yazdi, Niloofar Ayoobi

doi:10.1007/s00261-019-02372-x

Cited by 17 publications

(8 citation statements)

References 17 publications

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“…In summary, we have herein reported a 13 years observational study in a patient with MEN-1 syndrome who developed both functioning as well as NF-PNET with different contrast-enhancement patterns and biological behaviours. As current guidelines on active surveillance in patients with MEN-1 are mainly focused on lesions' diameters [7], this case shows that aside from dimension contrast-enhancement patterns of PNET should also be taken into account [12][13][14]. As far as the conservative surgical approach is concerned, this should be seriously reconsidered in patients with MEN-1 and much more so when a DCP is deemed necessary as in the present case [20].…”

Section: Discussionmentioning

confidence: 76%

“…Active surveillance is strongly recommended in patients with MEN-1 and is usually accomplished by a combination of EUS with either contrast-enhanced CT and/or MR [8-10]. Dimension, however, is not the only feature that should be taken into account when evaluating either familial or sporadic PNET as recent studies have emphasized that contrast-enhancement patterns may indeed be predictive of their differentiation grade and biological behavior [12][13][14]. Indeed, an arterial-enhancement ratio < 1.1, reported as the ratio between the attenuation of the tumor and that of the surrounding parenchyma should be viewed with caution even in lesion smaller than 2 cm according to Belousova et al [13].…”

Section: Discussionmentioning

confidence: 99%

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Gastrinomas and Non-functioning Pancreatic Endocrine Tumors in Multiple Endocrine Neoplasia Syndrome Type-1 (MEN-1)

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Boccadifuoco

Modica

et al. 2023

Preprint

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Purpose: Illustrate imaging findings of gastrinomas and non-functioning pancreatic endocrine tumors (NF-PNET) in a patient with multiple endocrine neoplasia type-1 (MEN-1) syndrome with a radiologic-pathologic correlation for both along with the results of a 13 yrs observational study. Methods: A 48 yrs old male patient with MEN-1 and a Zollinger-Ellison syndrome was submitted to a duodeno-cephalopancreatectomy (DCP) extended to the pancreatic body to remove several gastrinomas shown by an endoscopic-ultrasonography as well as a large (> 2 cm) hypo-vascular pancreatic nodule shown by a contrast-enhanced multi-detector CT (CE-MDCT). Further conventional (CT/MR) and functional imaging (68Ga-PET-DOTA-TOC) studies were performed over the next 13 years. Results: Up to 14 gastrin-positive NET-G1 (pT2,N1) as well as a single PNET-G2 (pT2,N0) were found at histo-pathology which also showed a NET-G1 in the uncinate process where CE-MDCT documented a 9 mm hyper-vascular nodule. A 7 mm pancreatic nodule with identical contrast-enhancement pattern was also shown at the level of the pancreatic tail which was left to preserve endocrine function. At this level, follow-up studies documented the occurence of a small (< 1 cm) hypo-vascular nodule which was metastatic at presentation and rapidly progressed under somastatin-analogs therapy whereas the hyper-vascular nodule remained stable over 13 years. Both the pancreatic lesion as well as the hepatic metastasis showed pathologic uptake of the radiotracer with a SUVmax of 6.3 and 29.5, respectively, allowing the patient to be scheduled for a Peptide Receptor Radionuclide Therapy performed with 29.6 GBq of 177Lu-Oxotreotide. Conclusions: Contrast-enhancement patterns are correlated with both the histological grade as well as the biological behaviour of PNETS.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Gastrinomas and Non-functioning Pancreatic Endocrine Tumors in Multiple Endocrine Neoplasia Syndrome Type-1 (MEN-1)

Camera

Boccadifuoco

Modica

et al. 2023

Preprint

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“…For patients with clinically suspected pNETs, imaging examinations are of great significance for diagnosis in determining the location of lesion, presence of metastasis, tumor grade, and guiding surgery or treatment plans. Traditional enhanced multidetector CT (MDCT) imaging has been the main force to diagnose and grade pNETs [ 5 , 6 ], and for most pNETs, the lesions are characterized by rich blood supply with intense and homogeneous "fast-in and fast-out" enhancement on arterial and portal phases. However, some pNETs are characterized by lack of blood supply, especially for large tumors with cystic degeneration, making them difficult to differentiate from pancreatic cancer and pancreatic cystic tumors [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Application of spectral CT combined with perfusion scan in diagnosis of pancreatic neuroendocrine tumors

Chen

Zhang

et al. 2022

Insights Imaging

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Background Pancreatic neuroendocrine tumors (pNETs) are heterogeneous tumors from the pancreatic neuroendocrine system, and early diagnosis is important for tumor prognosis and treatment. In this study, we aimed to explore the diagnostic value of spectral CT combined with perfusion scanning in improving the detection rate of pNETs. Methods From December 2018 to December 2020, 58 patients with clinically suspected pNETs were prospectively enrolled in the study for one-stop spectral CT combined with perfusion scanning, 36 patients were confirmed with pNETs by histopathology. An independent cohort of 30 patients with pNETs who underwent routine pancreatic perfusion scanning in our hospital during the same period were retrospectively collected. The image characters of pNETs versus tumor-free pancreatic parenchymal were examined. Results The detection rate of spectral CT combined with perfusion was 83.1–96.2%. CT values of the pNETs lesions under each single energy in the arterial phase were statistically higher than those of the adjacent normal pancreatic parenchyma. IC, WC and NIC, in the arterial phase of pNETs lesion were all statistically higher than those of the adjacent normal pancreatic parenchyma. The perfusion parameters of pNETs including BF, BV and MSI were significantly higher than those in normal parenchyma. The average effective radiation dose during the perfusion combined energy spectrum enhanced scanning process was 17.51 ± 2.18 mSv. Conclusion The one-stop spectral CT combined with perfusion scan improves the detection of pNETs according to morphological features, perfusion parameters and energy spectrum characters with a relatively small radiation dose.

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“…Recent studies stated that vitamin D deficiency has a crucial role in patients with T2D. It increases the incidence rate and worsens the patients' clinical condition [15,16]. The receptor of 1,25(OH)2D3 stimulates the insulin secretion in pancreatic beta-cells via direct or intracellular Ca way.…”

Section: Introductionmentioning

confidence: 99%

Association Between Glycemic Control Status and Serum Level of Vitamin D3 in Patients with Type 2 Diabetes: A Cross-Sectional Study

Aliniagerdroudbari

Farhangian

Babaniamansour

et al. 2022

Clinical Diabetology

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Objective: This study aimed to assess the association between glycemic control status and serum levels of vitamin D3 in Iranian patients with type 2 diabetes (T2D). Materials and methods: This was a cross-sectional study on 452 patients with T2D in Tehran, Iran, performed between September 2019 and September 2020. We assessed the diabetes laboratory test and vitamin D3 level in all participants using the Enzymatic Glucose Oxidase method. Data were analyzed using SPSS version 24. Results: a total of 452 patients were enrolled in this study (mean age: 59.4 ± 11.4 years, 63.5% females). Vitamin D deficiency was reported in half of the participants. Deficient vitamin D was significantly associated with higher mean level of hemoglobin A1c, fasting plasma glucose, total cholesterol, and low-density lipoprotein-cholesterol (p < 0.05). Multiple regression showed that the level of vitamin D3 could be a good predictor of hemoglobin A1c after adjusting for confounding variables affecting the hemoglobin A1c (regression coefficient: 0.442, 95% CI, 0.072-0.811, p = 0.063). Conclusions: With the alarming rates of vitamin D deficiency in patients with T2D, there was a significant direct association between vitamin D3 and hemoglobin A1c levels before and after adjusting for the associated

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Pancreatic neuroendocrine tumors (pNETs): the predictive value of MDCT characteristics in the differentiation of histopathological grades

Cited by 17 publications

References 17 publications

Gastrinomas and Non-functioning Pancreatic Endocrine Tumors in Multiple Endocrine Neoplasia Syndrome Type-1 (MEN-1)

Gastrinomas and Non-functioning Pancreatic Endocrine Tumors in Multiple Endocrine Neoplasia Syndrome Type-1 (MEN-1)

Application of spectral CT combined with perfusion scan in diagnosis of pancreatic neuroendocrine tumors

Association Between Glycemic Control Status and Serum Level of Vitamin D3 in Patients with Type 2 Diabetes: A Cross-Sectional Study

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