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Pancreatic neuroendocrine tumour (PNET): Staging accuracy of MDCT and its diagnostic performance for the differentiation of PNET with uncommon CT findings from pancreatic adenocarcinoma

  • Gastrointestinal
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Abstract

Purpose

To investigate staging accuracy of multidetector CT (MDCT) for pancreatic neuroendocrine tumour (PNET) and diagnostic performance for differentiation of PNET from pancreatic adenocarcinoma.

Material and methods

We included 109 patients with surgically proven PNET (NETG1 = 66, NETG2 = 31, NEC = 12) who underwent MDCT. Two reviewers assessed stage and presence of predefined CT findings. We analysed the relationship between CT findings and tumour grade. Using PNETs with uncommon findings, we also estimated the possibility of PNET or adenocarcinoma.

Results

Accuracy for T stage was 85–88 % and N-metastasis was 83–89 %. Common findings included well circumscribed, homogeneously enhanced, hypervascular mass, common in lower grade tumours (p < 0.05). Uncommon findings included ill-defined, heterogeneously enhanced, hypovascular mass and duct dilation, common in higher grade tumours (p < 0.05). Using 31 PNETs with uncommon findings, diagnostic performance for differentiation from adenocarcinoma was 0.760–0.806. Duct dilatation was an independent predictor for adenocarcinoma (Exp(B) = 4.569). PNETs with uncommon findings were associated with significantly worse survival versus PNET with common findings (62.7 vs. 95.7 months, p < 0.001).

Conclusion

MDCT is useful for preoperative evaluation of PNET; it not only accurately depicts the tumour stage but also prediction of tumour grade, because uncommon findings were more common in higher grade tumours.

Key Points

• CT accurately depicts the T stage and node metastasis of PNET.

• Uncommon findings were more common in higher grade tumours.

• CT information may be beneficial for optimal therapeutic planning.

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Acknowledgments

We thank Bonnie Hami, South Euclid, Ohio, and Jeehyun Kim, Berkeley, California, for editorial assistance in the preparation of this manuscript.

The scientific guarantor of this publication is Joon Koo Han, M.D. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding, and have no conflicts of interest to declare. Young Jae Kim M.D. has significant statistical expertise and no complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained (IRB No. 1304-052-480). Written informed consent was waived by the Institutional Review Board. No study subjects or cohorts have been previously reported. Methodology: retrospective, diagnostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea

    Jung Hoon Kim, Jeong Min Lee, Joon Koo Han & Byung-Ihn Choi

  2. Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea

    Jung Hoon Kim, Jeong Min Lee, Joon Koo Han & Byung-Ihn Choi

  3. Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seodaemun-ku, Shinchon-dong 134, Seoul, 120-752, Korea

    Hyo Won Eun

  4. Department of Radiology, Soonchunhyang University Hospital, 657 Hannam-Dong, Youngsan-Ku, Seoul, 140-743, Republic of Korea

    Young Jae Kim

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  1. Jung Hoon Kim
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Correspondence to Jung Hoon Kim.

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Kim, J.H., Eun, H.W., Kim, Y.J. et al. Pancreatic neuroendocrine tumour (PNET): Staging accuracy of MDCT and its diagnostic performance for the differentiation of PNET with uncommon CT findings from pancreatic adenocarcinoma. Eur Radiol 26, 1338–1347 (2016). https://doi.org/10.1007/s00330-015-3941-7

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  • DOI: https://doi.org/10.1007/s00330-015-3941-7

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