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Qualitative imaging features of pancreatic neuroendocrine neoplasms predict histopathologic characteristics including tumor grade and patient outcome

  • Special Section: Neuroendocrine
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Objectives

To identify PanNEN imaging features associated with tumor grade and aggressive histopathological features.

Methods

Associations between histopathological and imaging features of resected PanNEN were retrospectively tested. Histopathologic features included WHO grade, lymphovascular invasion (LVI), growth pattern (infiltrative, circumscribed), and intratumoral fibrosis (mature, immature). Imaging features included size, degree/uniformity of enhancement, progressive enhancement, contour, infiltrative appearance (infiltrativeim), calcifications, cystic components, tumor thrombus, vascular occlusion (VO), duct dilatation, and atrophy. Multinomial logistic regression analyses evaluated the magnitude of associations. Association of variables with outcome was assessed using Cox-proportional hazards regression.

Results

133 patients were included. 3 imaging features (infiltrativeim, ill-defined contour [contourill], and VO) were associated with all histopathologic parameters and poor outcome. Increase in grade increased odds of contourill by 15.6 times (p = 0.0001, 95% CI 3.8–64.4). PanNEN with VO were 51.1 times (p = 0.0002, 6.5–398.6) more likely to demonstrate LVI. For PanNEN with contourill, infiltrative growth pattern was 51.3 times (p < 0.0001, 9.1–288.4), and fibrosis was 14 times (p = 0.0065, 2.1–93.7) more likely. Contourill was associated with decreased recurrence-free survival (p = 0.0003, HR 18.29, 3.83–87.3) and VO (p = 0.0004, HR6.08, 2.22–16.68) with decreased overall survival.

Conclusions

Infiltrativeim, contourill, and VO on imaging are associated with higher grade/histopathological parameters linked to tumor aggression, and poor outcome.

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Author information

Author notes

  1. Motoyo Yano

    Present address: Department of Radiology, Mayo Clinic Arizona, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA

  2. Samantha Lancia & Amber Salter

    Present address: Section on Statistical Planning and Analysis, Department of Neurology, UT Southwestern Medical Center, Dallas, TX, USA

  3. Deyali Chatterjee

    Present address: Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA

Authors and Affiliations

  1. Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd. CB 8131, Saint Louis, MO, 63110, USA

    Motoyo Yano & Anup S. Shetty

  2. Department of Surgery, Washington University School of Medicine, St Louis, MO, USA

    Greg A. Williams, Chet W. Hammill & William G. Hawkins

  3. Division of Medical Oncology, Department of Internal Medicine, Washington University School of Medicine and Siteman Cancer Center, MO, St Louis, USA

    Nikolaos A. Trikalinos

  4. Department of Pathology, Washington University School of Medicine, St Louis, MO, USA

    Deyali Chatterjee

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Yano, M., Shetty, A.S., Williams, G.A. et al. Qualitative imaging features of pancreatic neuroendocrine neoplasms predict histopathologic characteristics including tumor grade and patient outcome. Abdom Radiol 47, 3971–3985 (2022). https://doi.org/10.1007/s00261-022-03430-7

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  • DOI: https://doi.org/10.1007/s00261-022-03430-7

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