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Minimal apparent diffusion coefficient in predicting the Ki-67 proliferation index of pancreatic neuroendocrine tumors

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Abstract

Purpose

To investigate the diagnostic performance of the minimal apparent diffusion coefficient (ADCmin) to distinguish between pancreatic neuroendocrine tumors (Pan-NETs) with low and high Ki-67 proliferation index values and to evaluate the relationship between ADCmin and the Ki-67 proliferation index.

Methods

Pre-operative magnetic resonance imaging data and postoperative Ki-67 proliferation index data of 42 patients with primary neuroendocrine tumor of the pancreas from November 2014 to March 2021 were included in this retrospective study. According to the Ki-67 proliferation index value, Pan-NETs were divided into a high-expression group (Ki-67 ≥ 10%, n = 17) and low-expression group (Ki-67 < 10%, n = 25), and mean ADC (ADCmean) and ADCmin values were compared between groups using receiver operating characteristic (ROC) curves to evaluate the performance of ADCmean and ADCmin in judging the expression level of Ki-67 proliferation index. The relationship between ADCmin and the Ki-67 proliferation index was also evaluated.

Results

The ADCmin was significantly higher in the low-expression group (Z = − 3.537, p < 0.01). The area under the ROC curve (AUC) for ADCmin was 0.825, which was higher than that for ADCmean (0.781). Using 1.32 × 10–3 mm2/s as the optimal discriminating threshold, the sensitivity, specificity, accuracy, and positive and negative predictive values of the two groups were 80%, 88.2%, 83.3%, 90%, and 75%, respectively. The ADCmin of Pan-NETs showed a significant negative correlation with the Ki-67 proliferation index (rs = − 0.634, p < 0.001).

Conclusion

The ADCmin is a potential imaging biomarker, which may be helpful for non-invasive preoperative prediction of the Ki-67 proliferation index of Pan-NETs and the subsequent planning of appropriate treatment.

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Funding

This study was supported by grants from the National Natural Science Foundation of China (81772006).

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Author notes

    Authors and Affiliations

    1. Department of Radiology, Lanzhou University Second Hospital, Lanzhou, 730000, China

      Yi**g **e, **anwang Liu, **aoyu Huang, Qing Zhou & Junlin Zhou

    2. Department of Nuclear Medicine, Lanzhou University Second Hospital, Lanzhou, 730000, China

      Yongjun Luo

    3. Department of Pathology, Lanzhou University Second Hospital, Lanzhou, 730000, China

      Qian Niu

    4. Second Clinical School, Lanzhou University, Lanzhou, 730000, China

      Yi**g **e, **anwang Liu, **aoyu Huang, Qing Zhou & Yongjun Luo

    5. Department of Radiology, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, 730000, China

      Shipeng Zhang

    6. Key Laboratory of Medical Imaging of Gansu Province, Lanzhou University Second Hospital, Lanzhou, 730000, China

      Yi**g **e, **anwang Liu, **aoyu Huang, Qing Zhou, Yongjun Luo & Junlin Zhou

    7. Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, 730000, China

      Yi**g **e, **anwang Liu, **aoyu Huang, Qing Zhou, Yongjun Luo & Junlin Zhou

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    1. Yi**g **e
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    Contributions

    YX conceptualization, methodology, software, writing—original draft. SZ methodology, writing—original draft. XL resources, investigation, revision. XH statistical analysis. QZ methodology, validation. YL visualization, software. QN pathological interpretation. JZ conceptualization, methodology, supervision, funding acquisition. Conceptualization YX and JZ. Writing—original draft preparation YX and SZ. Writing—review and editing QZ, YL, XL, PT, LX and JZ. Statistical analysis XH. Pathological interpretation QN. All authors have read and agreed to the published version of the manuscript.

    Corresponding author

    Correspondence to Junlin Zhou.

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    The authors declare that they have no conflict of interest.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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    The study was approved by the Institutional Review Board, and informed consent was waived due to retrospective analysis of the study.

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    Yi**g **e and Shipeng Zhang contributed equally to this work.

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    **e, Y., Zhang, S., Liu, X. et al. Minimal apparent diffusion coefficient in predicting the Ki-67 proliferation index of pancreatic neuroendocrine tumors. Jpn J Radiol 40, 823–830 (2022). https://doi.org/10.1007/s11604-022-01262-5

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    • DOI: https://doi.org/10.1007/s11604-022-01262-5

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