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Contrast enhancement pattern on multidetector CT predicts malignancy in pancreatic endocrine tumours

  • Oncology
  • Published:
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Abstract

Objectives

Preoperative suspicion of malignancy in pancreatic neuroendocrine tumours (pNETs) is mostly based on tumour size. We retrospectively reviewed the contrast enhancement pattern (CEP) of a series of pNETs on multiphasic multidetector computed tomography (MDCT), to identify further imaging features predictive of lesion aggressiveness.

Methods

Sixty pNETs, diagnosed in 52 patients, were classified based on CEP as: type A showing early contrast enhancement and rapid wash-out; type B presenting even (B1) or only (B2) late enhancement. All tumours were resected allowing pathologic correlations.

Results

Nineteen pNETs showed type A CEP (5–20 mm), 29 type B1 CEP (5–80 mm) and 12 type B2 (15–100 mm). All tumours were classified as well differentiated tumours, 19 were benign (WDt-b), 15 with uncertain behaviour (WDt-u) and 26 carcinomas (WDC). None of A lesions were malignant (12 WDt-b; 7 WDt-u), all B2 lesions were WDC, 7 B1 lesions were WDt-b, 8 WDt-u and 14 WDC; 4/34 (12 %) lesions ≤2cm were WDC.

CEP showed correlation with all histological prognostic indicators.

Conclusions

Correlating with the lesion grading and other histological prognostic predictors, CEP may preoperatively suggest the behaviour of pNETs, assisting decisions about treatment. Moreover CEP allows recognition of malignant small tumours, incorrectly classified on the basis of their dimension.

Key Points

• Neuroendocrine pancreatic tumours (pNETs) show different post-contrast behaviour on CT.

• P NETs can be classified on the basis of contrast enhancement into three categories.

• CT classification of pNETs shows strong correlation with histological prognostic factors.

• CT pattern may suggest the optimal management of pNETs.

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Acknowledgments

The scientific guarantor of this publication is Salvatore Mazzeo 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. No complex statistical methods were necessary for this paper. Institutional review board approval was not required because our study is a retrospective review of standard preoperative CT examinations. Written informed consent was not required for this study because our study is a retrospective review of standard preoperative CT examinations. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

Conflict of interest

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Authors and Affiliations

  1. Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy

    Carla Cappelli, Salvatore Mazzeo, Rosa Cervelli, Benedetta Pontillo Contillo & Carlo Bartolozzi

  2. General and Transplant Surgery, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy

    Ugo Boggi

  3. Pathology, Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy

    Daniela Campani & Niccola Funel

  4. Azienda Ospedaliero-Universitaria Pisana-Radiodiagnostica I, Via Paradisa 2, 56124, Pisa, Italy

    Carla Cappelli

Authors
  1. Carla Cappelli
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  2. Ugo Boggi
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  3. Salvatore Mazzeo
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  4. Rosa Cervelli
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  5. Daniela Campani
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  7. Benedetta Pontillo Contillo
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  8. Carlo Bartolozzi
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Correspondence to Carla Cappelli.

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Cappelli, C., Boggi, U., Mazzeo, S. et al. Contrast enhancement pattern on multidetector CT predicts malignancy in pancreatic endocrine tumours. Eur Radiol 25, 751–759 (2015). https://doi.org/10.1007/s00330-014-3485-2

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  • DOI: https://doi.org/10.1007/s00330-014-3485-2

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