Prognostic value of CT findings to predict survival outcomes in patients with pancreatic neuroendocrine neoplasms: a single institutional study of 161 patients

Kim, Dong Wook; Kim, Hyoung Jung; Kim, Kyung Won; Byun, Jae Ho; Kim, So Yeon; Song, Ki Byung; Ramaiya, Nikhil H.; Tirumani, Sree Harsha; Hong, Seung‐Mo

doi:10.1007/s00330-015-3943-5

Cited by 29 publications

(9 citation statements)

References 24 publications

(37 reference statements)

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“…19,20 Prior reports have found that tumor size larger than 2 cm, a pancreatic head localization, a high tumor grade, and the presence of suspicious N+ at imaging, are associated with an increased risk of N+. 12,18,[21][22][23][24] Nevertheless, it is unclear whether the initial diagnostic workup leads to an improved diagnostic accuracy for the detection of N+ NF-PanNETs.…”

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confidence: 99%

A Single-center Prospective Observational Study Investigating the Accuracy of Preoperative Diagnostic Procedures in the Assessment of Lymph Node Metastases in Nonfunctioning Pancreatic Neuroendocrine Tumors

et al. 2022

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To determine the accuracy of preoperative imaging, including contrast-enhanced computed tomography (CE-CT), endoscopic ultrasound (EUS), and 68 Gallium-DOTATOC positron emission tomography ( 68 Ga-DOTATOC PET), in identifying nodal metastases (N+) in sporadic nonfunctioning pancreatic neuroendocrine tumors (NF-PanNETs). Background: An accurate preoperative identification of N+ in NF-PanNETs is critical for surgical planning. The accuracy of different imaging techniques in detecting lymph node (LN) metastases in NF-PanNETs has been poorly investigated. Methods: All consecutive patients undergoing surgery for sporadic NF-PanNETs (2018 were enrolled in a prospective study (DETECTYON; NCT03918759). The accuracy of preoperative imaging techniques in detecting N+ was assessed through sensitivity, specificity positive and negative predictive values. Results: Overall, 100 patients with NF-PanNETs underwent CE-CT, EUS, and 68 Ga-DOTATOC PET before pancreatic resection. LN metastases were found in 42 cases (42%). Sensitivity, specificity, positive predictive value, and negative predictive value of different imaging techniques were 26%, 95%, 79%, 64% for CE-CT, 19%, 98%, 89%, 63% for EUS, and 12%, 95%, 63%, 60% for 68 Ga-DOTATOC PET, respectively. Radiologic tumor size > 4 cm and the presence of radiologic N+ at ≥ 1 imaging were independent predictors of N+ at pathology. The identification of N+ at ≥ 1 imaging technique was associated with a higher number of positive LNs compared with negative imaging (4 vs 2) (P = 0.012). Conclusions: CE-CT, EUS, and 68 Ga-DOTATOC PET are poorly sensitive in predicting nodal status in NF-PanNETs despite a high specificity.

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confidence: 99%

A Single-center Prospective Observational Study Investigating the Accuracy of Preoperative Diagnostic Procedures in the Assessment of Lymph Node Metastases in Nonfunctioning Pancreatic Neuroendocrine Tumors

et al. 2022

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“…However, Yamada et al's study was a small‐scale study and aimed to diagnose G1 and G2 tumors but not G3 tumors. Kim et al performed a multivariate analysis of the MSCT features of 161 patients with pNETs; they reported that the largest diameter (>3 cm), portal venous enhancement rate (≤1.1), and liver metastasis were more suggestive of poor prognosis and that the portal enhancement ratio showed high sensitivity and specificity (92.3% and 80.5%, respectively) in differentiating G3 from G1/2 pNETs. Toshima et al performed a study regarding the correlation between CT and MRI features and tumor grade; using univariate analysis, the study showed that the maximum diameter of the tumor, tumor shape, enhancement pattern, cystic degeneration, and apparent diffusion coefficient (ADC) were helpful in the determination of G1/2 and G3 tumors, and using a multivariate regression analysis they showed that a lower ADC ratio (ADC value of the lesion/ADC value of the parenchyma < 0.94), nonuniform enhancement, lobulated mass, and high signal intensity on T 2 WI suggest a diagnosis of G3 tumor.…”

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confidence: 99%

Noncontrast Radiomics Approach for Predicting Grades of Nonfunctional Pancreatic Neuroendocrine Tumors

Bian

Zhao

Jiang

et al. 2020

Magnetic Resonance Imaging

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Background Endoscopic ultrasound‐guided fine‐needle aspiration is associated with the accurate determination of tumor grade. However, because it is an invasive procedure there is a need to explore alternative noninvasive procedures. Purpose To develop and validate a noncontrast radiomics model for the preoperative prediction of nonfunctional pancreatic neuroendocrine tumor (NF‐pNET) grade (G). Study Type Retrospective, single‐center study. Subjects Patients with pathologically confirmed PNETs (139) were included. Field Strength/Sequence 3T/breath‐hold single‐shot fast‐spin echo T2‐weighted sequence and unenhanced and dynamic contrast‐enhanced T1‐weighted fat‐suppressed sequences. Assessment Tumor features on contrast MR images were evaluated by three board‐certified abdominal radiologists. Statistical Tests Multivariable logistic regression analysis was used to develop the clinical model. The least absolute shrinkage and selection operator method and linear discriminative analysis (LDA) were used to select the features and to construct a radiomics model. The performance of the models was assessed using the training cohort (97 patients) and the validation cohort (42 patients), and decision curve analysis (DCA) was applied for clinical use. Results The clinical model included 14 imaging features, and the corresponding area under the curve (AUC) was 0.769 (95% confidence interval [CI], 0.675–0.863) in the training cohort and 0.729 (95% CI, 0.568–0.890) in the validation cohort. The LDA included 14 selected radiomics features that showed good discrimination—in the training cohort (AUC, 0.851; 95% CI, 0.758–0.916) and the validation cohort (AUC, 0.736; 95% CI, 0.518–0.874). In the decision curves, if the threshold probability was 0.17–0.84, using the radiomics score to distinguish NF‐pNET G1 and G2/3, offered more benefit than did the use of a treat‐all‐patients or treat‐none scheme. Data Conclusion The developed radiomics model using noncontrast MRI could help differentiate G1 and G2/3 tumors, to make the clinical decision, and screen pNETs grade. Level of Evidence 4 Technical Efficacy Stage 2 J. Magn. Reson. Imaging 2020;52:1124–1136.

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“…Some previous reports have investigated the correlation between imaging characteristics and the PNET grade. PNENs are generally enhanced in the early phase on contrast-enhanced CT and MRI ( 26 - 29 ), whereas low enhancement is observed in malignant PNENs ( 30 - 33 ). FDG-PET often reveals an FDG accumulation in cases of malignant or highly proliferative PNENs ( 34 , 35 ).…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Neuroendocrine Neoplasm Invading the Entire Main Pancreatic Duct Diagnosed by a Preoperative Endoscopic Biopsy

et al. 2020

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A 78-year-old man was referred to our hospital for a detailed examination of a pancreatic tumor that filled the main pancreatic duct (MPD). The histological diagnosis of the endoscopic biopsy specimen was neuroendocrine tumor (NET) G3. The patient subsequently underwent total pancreatectomy. The histological diagnosis of the surgical specimen was also NET G3. This is the first report of a NET that occupied the MPD and was diagnosed by a preoperative endoscopic biopsy through the papilla of Vater. This case is a good example of a histopathological diagnostic method for pancreatic tumors invading the entire MPD.

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Prognostic value of CT findings to predict survival outcomes in patients with pancreatic neuroendocrine neoplasms: a single institutional study of 161 patients

Abstract: • CT is useful to predict survival outcomes in patients with PanNENs. • Survival outcomes are associated with portal enhancement ratio and hepatic metastases. • Portal enhancement ratio is prognostic CT biomarker in patients with PanNENs.

Cited by 29 publications

References 24 publications

A Single-center Prospective Observational Study Investigating the Accuracy of Preoperative Diagnostic Procedures in the Assessment of Lymph Node Metastases in Nonfunctioning Pancreatic Neuroendocrine Tumors

A Single-center Prospective Observational Study Investigating the Accuracy of Preoperative Diagnostic Procedures in the Assessment of Lymph Node Metastases in Nonfunctioning Pancreatic Neuroendocrine Tumors

Noncontrast Radiomics Approach for Predicting Grades of Nonfunctional Pancreatic Neuroendocrine Tumors

Pancreatic Neuroendocrine Neoplasm Invading the Entire Main Pancreatic Duct Diagnosed by a Preoperative Endoscopic Biopsy

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