Association between Pathologic Grade and Multiphase Computed Tomography Enhancement in Pancreatic Neuroendocrine Neoplasm.

Association between Pathologic Grade and Multiphase Computed Tomography Enhancement in Pancreatic Neuroendocrine Neoplasm.

J Gastroenterol Hepatol. 2018 Mar 07;:

Authors: Kang J, Ryu JK, Son JH, Lee JW, Choi JH, Lee SH, Kim YT

Abstract
BACKGROUND: Pancreatic neuroendocrine neoplasms (PanNENs) are rare diseases but gradually increasing in prevalence with different prognosis. Multiphase contrast-enhanced computed tomography (CT) is known as widely used imaging modality for the diagnosis of pancreatic tumors. We aimed to investigate whether CT enhancement pattern is associated with the pathologic tumor grade and can predict that of pancreatic neuroendocrine neoplasm.
METHODS: Ninety PanNEN patients who underwent multi-phase enhanced CT before pathologic diagnosis were retrospectively reviewed. CT enhancement values at each phase were measured and its relation with pathologic grade was assessed.
RESULTS: Ninety PanNENs included 62 G1 (68.9%), 21 G2 (23.3%), 7 G3 (7.8%). The enhancement values of the early arterial phase were significantly different among three groups (G1 119.4HU; G2; 94.7HU; G3 64.8HU, G1 vs. G2; p=0.043, G1 vs. G3; p=0.001, G2 vs. G3; p=0.027). In the late arterial phase, there was a difference between grade 1/2 and 3 but no significant difference between grade 1 and grade 2 (G1 164.3HU; G2 142.9HU; G3 94.1HU, G1 vs. G2; p=0.804, G1 vs. G3; p=0.016, G2 vs. G3; p=0. 0.022). The enhancement value of the portal phase did not differ significantly among the three groups. Diagnostic ability of the early arterial enhancement value for the differentiation of the G1 (cut-off 109.5HU; sensitivity 73.3%; specificity 62.5%) was comparable to that of the tumor size (cut-off 20.5mm; sensitivity 68.9%; specificity 66.7%) CONCLUSIONS: CT enhancement value at early arterial phase and its changing pattern can be a useful predictor for the differentiation of pathologic grade of PanNENs.

PMID: 29514405 [PubMed - as supplied by publisher]

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