Shape and Enhancement Characteristics of Pancreatic Neuroendocrine Tumor on Preoperative Contrast-enhanced Computed Tomography May be Prognostic Indicators

Okabe, Hidetoshi; Hashimoto, Daisuke; Chikamoto, Akira; Yoshida, Morikatsu; Taki, Katsunobu; Arima, Kei; Imai, Katsunori; Tamura, Yoshitaka; Ikeda, Osamu; Ishiko, Takatoshi; Uchiyama, Hideaki; Ikegami, Toru; Harimoto, Norifumi; Itoh, Shinji; Yamashita, Yo Ichi; Yoshizumi, Tomoharu; Beppu, Teruhiko; Yamashita, Yasuyuki; Baba, Hideo; Maehara, Yoshihiko

doi:10.1245/s10434-016-5630-4

Cited by 22 publications

(9 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cheng et al [18] found a strong correlation between the peri-spheroid solid stress distribution and spheroid shape, a result of the suppression of cell proliferation and induction of apoptotic cell death in regions of high mechanical stress. In addition, Mazurowski et al [19] reported that shape features were strongly associated with genomic subtypes and patient outcomes in lower-grade glioma, and Okabe et al [8] reported that irregular tumor shape on preoperative computed tomography was a negative prognostic factor after curative surgery for pancreatic neuroendocrine tumors. Therefore, we believe that there is a significant correlation between the shape of GIST and risk level.…”

Section: Discussionmentioning

confidence: 99%

“…CT features like location, contour, necrosis, enhancement pattern, and tumor calcification are associated with grades [4][5][6]; few studies report how tumor shape can be correlated with risk grading. In glioblastoma [7] or pancreatic neuroendocrine tumors [8], tumor shape is associated with the outcome. Therefore, we explored a novel method for quantifying the shape of GISTs using CT.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Risk stratification in GIST: shape quantification with CT is a predictive factor

Wei

Liang

et al. 2020

Eur Radiol

View full text Add to dashboard Cite

Background Tumor shape is strongly associated with some tumor's genomic subtypes and patient outcomes. Our purpose is to find the relationship between risk stratification and the shape of GISTs. Methods A total of 101 patients with primary GISTs were confirmed by pathology and immunohistochemistry and underwent enhanced CT examination. All lesions' pathologic sizes were 1 to 10 cm. Points A and B were the extremities of the longest diameter (LD) of the tumor and points C and D the extremities of the small axis, which was the longest diameter perpendicular to AB. The four angles of the quadrangle ABCD were measured and each angle named by its summit (A, B, C, D). For regular lesions, we took angles A and B as big angle (BiA) and small angle (SmA). For irregular lesions, we compared A/B ratio and D/C ratio and selected the larger ratio for analysis. The chi-square test, t test, ROC analysis, and hierarchical or binary logistic regression analysis were used to analyze the data. Results The BiA/SmA ratio was an independent predictor for risk level of GISTs (p = 0.019). With threshold of BiA at 90.5°, BiA/SmA ratio at 1.35 and LD at 6.15 cm, the sensitivities for high-risk GISTs were 82.4%, 85.3%, and 83.8%, respectively; the specificities were 87.1%, 71%, and 77.4%, respectively; and the AUCs were 0.852, 0.818, and 0.844, respectively. LD could not effectively distinguish between intermediate-risk and high-risk GISTs, but BiA could (p < 0.05). Shape and Ki-67 were independent predictors of the mitotic value (p = 0.036 and p < 0.001, respectively), and the accuracy was 87.8%. Conclusions Quantifying tumor shape has better predictive efficacy than LD in predicting the risk level and mitotic value of GISTs, especially for high-risk grading and mitotic value > 5/50HPF. Key Points • The BiA/SmA ratio was an independent predictor affecting the risk level of GISTs. LD could not effectively distinguish between intermediate-risk and high-risk GISTs, but BiA could. • Shape and Ki-67 were independent predictors of the mitotic value.• The method for quantifying the tumor shape has better predictive efficacy than LD in predicting the risk level and mitotic value of GISTs.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk stratification in GIST: shape quantification with CT is a predictive factor

Wei

Liang

et al. 2020

Eur Radiol

View full text Add to dashboard Cite

show abstract

“…Indeed, there is emerging evidence that the radiographic characteristics of pancreatic NET on CT correlate with clinical outcomes. 19 Extrapolating from the findings of the current study, it is possible that the echogenic appearance of NELM on transabdominal US may also be prognostic. If validated in future studies, transabdominal US could be added to the pre-operative assessment in order to help ascertain the risk of recurrence of patients with NELM.…”

Section: Discussionmentioning

confidence: 54%

Can echogenic appearance of neuroendocrine liver metastases on intraoperative ultrasonography predict tumor biology and prognosis?

Dogeas

Chong

Weiss

et al. 2018

HPB

View full text Add to dashboard Cite

show abstract

“…In the 2017, Zhu et al reported a significant association between the aspect of lesion borders (well-defined or ill-defined) on EUS and the grading of pNET [25]. Moreover, the association between irregular shape on CT scan and aggressiveness has been previously reported also in two large retrospective surgical series of pNET [26,27]. In our study, this feature was significant in the multivariate analysis in both pNETs and the other-than-pNET group, which indicates that this finding could reflect the infiltrative behavior of the nodule independently of its nature.…”

Section: Discussionmentioning

confidence: 86%

Endoscopic Ultrasound Features Associated with Malignancy and Aggressiveness of Nonhypovascular Solid Pancreatic Lesions: Results from a Prospective Observational Study

et al. 2019

View full text Add to dashboard Cite

Background and Study Aims On contrast-enhanced imaging studies, nonhypovascular (i. e., isovascular and hypervascular) patterns can be observed in solid pancreatic lesions (SPLs) of different nature, prognosis, and management. We aimed to identify endoscopic ultrasound (EUS) features of nonhypovascular SPLs associated with malignancy/aggressiveness. The secondary aims were EUS tissue acquisition (EUS-TA) outcome and safety in this setting of patients. Patients and Methods This prospective observational study included patients with nonhypovascular SPLs detected on cross-sectional imaging and referred for EUS-TA. Lesion features (size, site, margins, echotexture, vascular pattern, and upstream dilation of the main pancreatic duct) were recorded. Malignancy/aggressiveness was determined by evidence of carcinoma at biopsy/surgical pathology, signs of aggressiveness (perineural invasion, lymphovascular invasion, and/or microscopic tumor extension/infiltration or evidence of metastatic lymph nodes) in the surgical specimen, radiologic detection of lymph nodes or distant metastases, and/or tumor growth > 5 mm/6 months. Uni- and multivariate analyses were performed to assess the primary aim. Results A total of 154 patients with 161 SPLs were enrolled. 40 (24.8 %) lesions were defined as malignant/aggressive. Irregular margins and size > 20 mm were independent factors associated with malignancy/aggressiveness (p < 0.001, OR = 5.2 and p = 0.003, OR = 2.1, respectively). However, size > 20 mm was not significant in the subgroup of other-than-neuroendocrine tumor (NET) lesions. The EUS-TA accuracy was 92 %, and the rate of adverse events was 4 %. Conclusion Irregular margins on EUS are associated with malignancy/aggressiveness of nonhypovascular SPLs. Size > 20 mm should be considered a malignancy-related feature only in NET patients. EUS-TA is safe and highly accurate for differential diagnosis in this group of patients.

show abstract

Shape and Enhancement Characteristics of Pancreatic Neuroendocrine Tumor on Preoperative Contrast-enhanced Computed Tomography May be Prognostic Indicators

Abstract: Irregular tumor shape/enhancement on preoperative computed tomography is a negative prognostic factor after curative surgery for PNET.

Cited by 22 publications

References 20 publications

Risk stratification in GIST: shape quantification with CT is a predictive factor

Risk stratification in GIST: shape quantification with CT is a predictive factor

Can echogenic appearance of neuroendocrine liver metastases on intraoperative ultrasonography predict tumor biology and prognosis?

Endoscopic Ultrasound Features Associated with Malignancy and Aggressiveness of Nonhypovascular Solid Pancreatic Lesions: Results from a Prospective Observational Study

Contact Info

Product

Resources

About