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Prevalence of hepatic lesion types defined by T2-weighted and dynamic gadolinium-enhanced MR imaging in patients with metastasized neuroendocrine tumors

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Abstract

Purpose

Identifying liver metastases from neuroendocrine tumors (NETs) is a pretherapeutic challenge in patients who are candidates for liver resection. The aims of our study are to characterize and determine the frequency of different MRI characteristics of liver metastases caused by NETs in a lesion-by-lesion analysis and to determine the frequency of monomorphous and polymorphous metastases in a patient-by-patient analysis.

Methods

This retrospective study involved 47 patients with liver metastases arising from histologically confirmed NETs. In a lesion-by-lesion analysis, we classified these metastases according to their MRI characteristics as follows: hypervascular lesions with homogeneous or peripheral enhancement, hypovascular lesions, pure cystic lesions, and mixed solid/cystic lesions. In the patient-by-patient analysis, we distinguished patients whose metastases had the same MRI characteristics from patients with mixed lesion characteristics.

Results

A total of 376 metastases were analyzed. Of these, 84.3% (n = 317) were hypervascular, with 51.9% showing homogeneous enhancement and 32.4% (n = 122) showing peripheral enhancement. Another 7.4% (n = 28) were hypovascular, 5.3% (n = 20) were pure cystic, and 2.9% (n = 11) were mixed solid/cystic. After excluding three patients with solitary lesions, 40.9% of patients (n = 18) had mixed-type lesions, consisting of hypervascular lesions with either homogeneous or peripheral enhancement in 27.3% of cases (n = 12), while 59.1% of patients (n = 26) had identical lesions.

Conclusion

Approximately 15% of metastases have atypical MRI characteristics and are either hypovascular or cystic. Metastases with different MRI characteristics coexist in 40% of patients.

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Authors and Affiliations

  1. CHU Nancy, Department of Radiology, Brabois Adults Hospital, 54000, Nancy, France

    S. Milin, X. Orry & V. Laurent

  2. CHU Nancy, Department of Abdominal Surgery, Brabois Adults Hospital, 54000, Nancy, France

    L. Brunaud & L. Bresler

  3. Faculte de Medecine, Universite de Lorraine, 54000, Nancy, France

    L. Brunaud, X. Orry, C. Bastien, M. Klein, L. Bresler & V. Laurent

  4. CHU Nancy, Department of Pathology, Brabois Adults Hospital, 54000, Nancy, France

    C. Bastien

  5. CHU Nancy, Department of Endocrinology, Brabois Adults Hospital, 54000, Nancy, France

    M. Klein

  6. INSERM, U947, IADI, 54000, Nancy, France

    V. Laurent

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  1. S. Milin
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Correspondence to S. Milin.

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The authors declare that they have no conflict of interest.

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For this type of study, formal consent is not required.

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The Institutional Review Board approved the study and did not require additional informed consent for reviewing the patients’ medical records and images.

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Milin, S., Brunaud, L., Orry, X. et al. Prevalence of hepatic lesion types defined by T2-weighted and dynamic gadolinium-enhanced MR imaging in patients with metastasized neuroendocrine tumors. Abdom Radiol 41, 2132–2141 (2016). https://doi.org/10.1007/s00261-016-0814-8

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  • DOI: https://doi.org/10.1007/s00261-016-0814-8

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