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Japanese Journal of Radiology

, Volume 35, Issue 5, pp 242–253 | Cite as

Is the combination of MR and CT findings useful in determining the tumor grade of pancreatic neuroendocrine tumors?

  • Fumihito ToshimaEmail author
  • Dai Inoue
  • Takahiro Komori
  • Kotaro Yoshida
  • Norihide Yoneda
  • Tetsuya Minami
  • Osamu Matsui
  • Hiroko Ikeda
  • Toshifumi Gabata
Original Article

Abstract

Purpose

To retrospectively elucidate the findings useful in determining the tumor grade of pancreatic neuroendocrine tumors (PNETs) by combined assessment of magnetic resonance (MR) and dynamic computed tomography (CT) images.

Materials and methods

Eighty-nine patients with PNETs (96 lesions) were included, and classified as G1, 59; G2, 29; and G3, 8 lesions. Image analysis included lesion diameter, shape, enhancement pattern on arterial phase (AP) and delayed phase CT images, calcification, cystic portion, main pancreatic duct dilatation, signal-intensity on T1-, T2-weighted MR images, and appearance of apparent diffusion coefficient (ADC).

Results

Significant differences among G1, G2, and G3 groups were noted in tumor maximal diameter (p < 0.0001), shape (p < 0.0001), enhancement pattern on AP image (p < 0.0001), cystic portion (p = 0.012), and ADC finding. In multivariate analysis, ADC finding was the independent factor (p = 0.002). The combination findings of low ADC ratio (ADC value of the lesion/ADC value of the parenchyma <0.94), not homogeneous hyper-attenuation, lobulated shape, and hyper-intensity on T2-weighted image were suggestive of G2 or G3 with a probability of 100%. Conversely, all lesions with high ADC ratio and small size (≤25 mm) belonged to the G1 group.

Conclusion

Combined assessment of MR and CT findings could improve the prediction of tumor grading in PNETs.

Keywords

Pancreatic neuroendocrine tumors Neuroendocrine tumors G1 Neuroendocrine tumors G2 Neuroendocrine carcinoma Magnetic resonance imaging (MRI) Computed tomography (CT) 

Notes

Funding

The authors state that this work has not received any funding.

Conflict of interest

The authors declare no conflict of interest associated with this manuscript.

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Copyright information

© Japan Radiological Society 2017

Authors and Affiliations

  • Fumihito Toshima
    • 1
    Email author
  • Dai Inoue
    • 1
  • Takahiro Komori
    • 1
  • Kotaro Yoshida
    • 1
  • Norihide Yoneda
    • 1
  • Tetsuya Minami
    • 1
  • Osamu Matsui
    • 1
  • Hiroko Ikeda
    • 2
  • Toshifumi Gabata
    • 1
  1. 1.Department of RadiologyKanazawa University Graduate School of Medical ScienceKanazawaJapan
  2. 2.Department of PathologyKanazawa University Graduate School of Medical ScienceKanazawaJapan

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