Skip to main content
Erschienen in: Abdominal Radiology 12/2017

17.06.2017

A comparison of enhancement patterns on dynamic enhanced CT and survival between patients with pancreatic neuroendocrine tumors with and without intratumoral fibrosis

verfasst von: Cherry Kim, Jae Ho Byun, Seung-Mo Hong, Soyeon An, Jin Hee Kim, Seung Soo Lee, Hyoung Jung Kim

Erschienen in: Abdominal Radiology | Ausgabe 12/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To compare CT findings and survival between patients with pancreatic neuroendocrine tumors (pNETs) with and without fibrosis.

Methods

Forty-five pNET patients with intratumoral fibrosis (group A) were matched for age, gender, and tumor size and grade with 45 pNET patients without (group B), and CT images were retrospectively reviewed. Hounsfield units (HUs) of tumors in unenhanced, arterial and portal phases, HU ratio (tumor to normal parenchyma) in each phase, enhancement patterns, visible enhancement pattern changes, and survival were compared.

Results

Group A showed progressive enhancement patterns, while group B showed early enhancement and wash-out patterns (p < 0.05). HUs of tumors and HU ratio in the unenhanced phase were significantly higher in group A than group B (p ≤ 0.024), whereas those in the arterial phase were significantly lower in group A than group B (p ≤ 0.003). Peripheral to full or peripheral to peripheral enhancement change was more frequent in group A, while full to full enhancement change was more frequent in group B (p < 0.05). Group A showed significantly lower overall survival than group B (p = 0.029).

Conclusions

pNETs with fibrosis showed a progressive enhancement pattern and worse overall survival than pNETs without, which showed an early enhancement and wash-out pattern.
Literatur
1.
Zurück zum Zitat Bosman FT, Carneiro F, Hruban RH, Theise ND (2010) WHO classification of tumours of the digestive system, 4th edn. Lyon: IARC Bosman FT, Carneiro F, Hruban RH, Theise ND (2010) WHO classification of tumours of the digestive system, 4th edn. Lyon: IARC
3.
Zurück zum Zitat Franko J, Feng W, Yip L, Genovese E, Moser AJ (2010) Non-functional neuroendocrine carcinoma of the pancreas: incidence, tumor biology, and outcomes in 2158 patients. J Gastrointest Surg 14(3):541–548. doi:10.1007/s11605-009-1115-0 CrossRefPubMed Franko J, Feng W, Yip L, Genovese E, Moser AJ (2010) Non-functional neuroendocrine carcinoma of the pancreas: incidence, tumor biology, and outcomes in 2158 patients. J Gastrointest Surg 14(3):541–548. doi:10.​1007/​s11605-009-1115-0 CrossRefPubMed
8.
Zurück zum Zitat Kim DW, Kim HJ, Kim KW, et al. (2015) Neuroendocrine neoplasms of the pancreas at dynamic enhanced CT: comparison between grade 3 neuroendocrine carcinoma and grade 1/2 neuroendocrine tumour. Eur Radiol 25(5):1375–1383. doi:10.1007/s00330-014-3532-z CrossRefPubMed Kim DW, Kim HJ, Kim KW, et al. (2015) Neuroendocrine neoplasms of the pancreas at dynamic enhanced CT: comparison between grade 3 neuroendocrine carcinoma and grade 1/2 neuroendocrine tumour. Eur Radiol 25(5):1375–1383. doi:10.​1007/​s00330-014-3532-z CrossRefPubMed
9.
Zurück zum Zitat Hyodo R, Suzuki K, Ogawa H, Komada T, Naganawa S (2015) Pancreatic neuroendocrine tumors containing areas of iso- or hypoattenuation in dynamic contrast-enhanced computed tomography: spectrum of imaging findings and pathological grading. Eur J Radiol 84(11):2103–2109. doi:10.1016/j.ejrad.2015.08.014 CrossRefPubMed Hyodo R, Suzuki K, Ogawa H, Komada T, Naganawa S (2015) Pancreatic neuroendocrine tumors containing areas of iso- or hypoattenuation in dynamic contrast-enhanced computed tomography: spectrum of imaging findings and pathological grading. Eur J Radiol 84(11):2103–2109. doi:10.​1016/​j.​ejrad.​2015.​08.​014 CrossRefPubMed
10.
Zurück zum Zitat Rodallec M, Vilgrain V, Couvelard A, et al. (2006) Endocrine pancreatic tumours and helical CT: contrast enhancement is correlated with microvascular density, histoprognostic factors and survival. Pancreatology 6(1–2):77–85. doi:10.1159/000090026 CrossRefPubMed Rodallec M, Vilgrain V, Couvelard A, et al. (2006) Endocrine pancreatic tumours and helical CT: contrast enhancement is correlated with microvascular density, histoprognostic factors and survival. Pancreatology 6(1–2):77–85. doi:10.​1159/​000090026 CrossRefPubMed
11.
Zurück zum Zitat d’Assignies G, Couvelard A, Bahrami S, et al. (2009) Pancreatic endocrine tumors: tumor blood flow assessed with perfusion CT reflects angiogenesis and correlates with prognostic factors. Radiology 250(2):407–416. doi:10.1148/radiol.2501080291 CrossRefPubMed d’Assignies G, Couvelard A, Bahrami S, et al. (2009) Pancreatic endocrine tumors: tumor blood flow assessed with perfusion CT reflects angiogenesis and correlates with prognostic factors. Radiology 250(2):407–416. doi:10.​1148/​radiol.​2501080291 CrossRefPubMed
12.
Zurück zum Zitat Kim DW, Kim HJ, Kim KW, et al. (2016) Prognostic value of CT findings to predict survival outcomes in patients with pancreatic neuroendocrine neoplasms: a single institutional study of 161 patients. Eur Radiol 26(5):1320–1329. doi:10.1007/s00330-015-3943-5 CrossRefPubMed Kim DW, Kim HJ, Kim KW, et al. (2016) Prognostic value of CT findings to predict survival outcomes in patients with pancreatic neuroendocrine neoplasms: a single institutional study of 161 patients. Eur Radiol 26(5):1320–1329. doi:10.​1007/​s00330-015-3943-5 CrossRefPubMed
13.
Zurück zum Zitat Hoshino A, Aimoto T, Suzuki H, et al. (2014) A case of nonfunctioning pancreatic endocrine tumor with atypical imaging findings due to prominent fibrosis of the tumor stroma. J Nippon Med School 81(5):346–352CrossRef Hoshino A, Aimoto T, Suzuki H, et al. (2014) A case of nonfunctioning pancreatic endocrine tumor with atypical imaging findings due to prominent fibrosis of the tumor stroma. J Nippon Med School 81(5):346–352CrossRef
15.
16.
Zurück zum Zitat Couvelard A, O’Toole D, Turley H, et al. (2005) Microvascular density and hypoxia-inducible factor pathway in pancreatic endocrine tumours: negative correlation of microvascular density and VEGF expression with tumour progression. Br J Cancer 92(1):94–101. doi:10.1038/sj.bjc.6602245 CrossRefPubMed Couvelard A, O’Toole D, Turley H, et al. (2005) Microvascular density and hypoxia-inducible factor pathway in pancreatic endocrine tumours: negative correlation of microvascular density and VEGF expression with tumour progression. Br J Cancer 92(1):94–101. doi:10.​1038/​sj.​bjc.​6602245 CrossRefPubMed
17.
Zurück zum Zitat Takahashi Y, Akishima-Fukasawa Y, Kobayashi N, et al. (2007) Prognostic value of tumor architecture, tumor-associated vascular characteristics, and expression of angiogenic molecules in pancreatic endocrine tumors. Clin Cancer Res 13(1):187–196. doi:10.1158/1078-0432.CCR-06-1408 CrossRefPubMed Takahashi Y, Akishima-Fukasawa Y, Kobayashi N, et al. (2007) Prognostic value of tumor architecture, tumor-associated vascular characteristics, and expression of angiogenic molecules in pancreatic endocrine tumors. Clin Cancer Res 13(1):187–196. doi:10.​1158/​1078-0432.​CCR-06-1408 CrossRefPubMed
18.
Zurück zum Zitat Marion-Audibert AM, Barel C, Gouysse G, et al. (2003) Low microvessel density is an unfavorable histoprognostic factor in pancreatic endocrine tumors. Gastroenterology 125(4):1094–1104CrossRefPubMed Marion-Audibert AM, Barel C, Gouysse G, et al. (2003) Low microvessel density is an unfavorable histoprognostic factor in pancreatic endocrine tumors. Gastroenterology 125(4):1094–1104CrossRefPubMed
Metadaten
Titel
A comparison of enhancement patterns on dynamic enhanced CT and survival between patients with pancreatic neuroendocrine tumors with and without intratumoral fibrosis
verfasst von
Cherry Kim
Jae Ho Byun
Seung-Mo Hong
Soyeon An
Jin Hee Kim
Seung Soo Lee
Hyoung Jung Kim
Publikationsdatum
17.06.2017
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 12/2017
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-017-1212-6

Weitere Artikel der Ausgabe 12/2017

Abdominal Radiology 12/2017 Zur Ausgabe

Classics in Abdominal Imaging

A “hanging” bladder stone

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.