Pancreatic neuroendocrine tumors (pNETs): the predictive value of MDCT characteristics in the differentiation of histopa
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PANCREAS
Pancreatic neuroendocrine tumors (pNETs): the predictive value of MDCT characteristics in the differentiation of histopathological grades Faeze Salahshour1 · Mohammad‑Mehdi Mehrabinejad1,3 · Ali Zare Dehnavi1,3 · Abbas Alibakhshi2 · Habibollah Dashti2 · Mohammad‑Ali Ataee1 · Niloofar Ayoobi Yazdi1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To investigate the correlation between multiple detector computed tomography (MDCT) features of pancreatic neuroendocrine tumors (pNETs) and histopathologic grade and find valuable imaging criteria for grade prediction. Material and methods MDCT of 61 patients with 65 masses, which pNETs were approved histopathologically, underwent revision retrospectively. Each MDCT was evaluated for various radiologic characteristics. Absolute and relative (R: tumor/ pancreas, D: tumor–pancreas) tumor enhancements were calculated in multiple post contrast phases. Results 61 patients [mean age = 50.70 ± 14.28 y/o and 30(49.2%) were male] were evaluated and classified into 2 groups histopathologically: G1: 32 (49.2%) and G2,3: 33 (50.8%). Significant relationships were observed between histopathologic tumor grade regarding age (p = 0.006), the longest tumor size (p = 0.006), presence of heterogeneity (p 20 were placed in the G3 group. However, in the 2017 version, lesions with the above-mentioned ki-67 figures are categorized into two subgroups based on their morphology: well differentiated (NET grade 3) and poorly differentiated (NEC grade 3) [11]. As our study only consists of 5 (7.7%) grade 3 lesions, which were merged to the G2 group, it seems that the distinction of these five cases by the new version will not cause a significant change in the results of the study.
MDCT imaging technique All CT scan examinations were carried out on either the Lightspeed 64-detector CT )GE Healthcare, Milwaukee, USA( or the Siemens SOMATOM Emotion (16 slices, Erlangen, Germany( MDCT scanner. The imaging parameters for both non-contrast and contrast-enhanced phases were 2–3 mm section thickness; beam collimation of 0.6–2 mm; 120 kVp tube voltage; tube current, 150–250 mAs; tube rotation speed of 0.75 seconds; and gantry rotation times, 0.5–0.75 s. Dynamic CT images, including non-contrast, arterial, portal venous, and delayed phase imaging (at 0, 22–40, 52–70, and 180 seconds, respectively), were performed for 53(86.8%) patients (57 (87.6%) tumors), and the remaining 8 (13.1%) patients (8 (12.3%) pNETs) had less than four but at least one contrast-enhanced phase MDCT. Following the non-contrast imaging, non-ionic iodinated contrast (80–100 ml of Omnipaque (Daiichi Sankyo, Tokyo, Japan)) with a concentration of 350 mg/ml and the speed rate
Abdominal Radiology
of 4 ml/s, followed by 30-40 ml saline flush was injected into peripheral veins.
Image analysis Two radiologists with 8 and 12 years of experience in abdominal radiology and blinded to pathology reports independently evaluated MDCT features. Imaging features were divided into the two catego
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