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Arterial vs pancreatic phase: which is the best choice in the evaluation of pancreatic endocrine tumours with multidetector computed tomography (MDCT)?

Fase arteriosa vs fase pancreatica: qual’è la scelta migliore nella valutazione dei tumori endocrini pancreatici con TC multidetettore (MDCT)?

  • Abdominal Radiology Radiologia Addominale
  • Published:
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Abstract

Purpose

The aim of this study was to assess whether the pancreatic phase may replace the arterial phase in the evaluation of endocrine pancreatic tumours.

Materials and methods

Twenty-nine endocrine pancreatic lesions with definitive morphological and immunohistochemical characterisation after surgical treatment (n=24) or fine-needle-aspiration cytology under endoscopic ultrasonography guidance (n=5) were retrospectively evaluated. All lesions were studied with triple-phase 16-row multidetector computed tomography (MDCT). Images obtained during each phase were separately interpreted by two senior radiologists experienced in pancreatic pathology and who were blinded to surgical results. Endocrine tumour and normal pancreas attenuation and the mean absolute tumour-to-gland attenuation difference were measured in each phase, and data were analysed with Student’s t test. Visualisation of arterial vascular abnormalities and hypervascular liver metastases in the arterial and pancreatic phases and the diagnostic contribution of the two phases were compared.

Results

For both radiologists, the mean absolute tumour-to-gland attenuation difference was significantly higher (p<0.05) in the pancreatic phase (40±53 HU and 34±56 HU) than in the arterial phase (31±38 HU and 26±43 HU). There were no differences in the detection of arterial vascular abnormalities or hypervascular liver metastases in the two phases. The diagnostic contribution was higher in the pancreatic phase.

Conclusions

In our experience, the pancreatic phase can replace the arterial phase in the evaluation of pancreatic endocrine tumours.

Riassunto

Obiettivo

Determinare se la fase pancreatica possa sostituire quella arteriosa nella valutazione di tumori endocrini pancreatici.

Materiali e metodi

Sono state valutate retrospettivamente 29 lesioni endocrine pancreatiche, con diagnosi definitiva alla valutazione morfologica e immuno-istochimica, dopo trattamento chirurgico (n=24) o prelievo citologico sotto guida ecoendoscopica (n=5). Tutte le lesioni sono state studiate con MDCT (16 canali), con tecnica trifasica. Le immagini ottenute in ciascuna fase sono state interpretate da due radiologi, esperti in patologia pancreatica, all’oscuro delle diagnosi definitive, valutando le densità di ghiandola pancreatica e tumore e la differenza di attenuazione tumore-ghiandola in valore assoluto, in ogni fase; i dati ottenuti sono stati analizzati con il test t di Student. Sono state inoltre confrontate la capacità delle due fasi nel visualizzare anomalie vascolari arteriose e metastasi epatiche ipervascolari e il loro contributo alla confidenza diagnostica.

Risultati

Per entrambi i radiologi il valore assoluto della differenza di attenuazione tumore-ghiandola in fase pancreatica (40±53 HU e 34±56 HU) è risultata significativamente maggiore (p<0,05) di quella ottenuta in fase arteriosa (31±38 HU e 26±43 HU). Non c’era differenza nella detezione di anomalie vascolari arteriose e metastasi epatiche ipervascolari nelle due fasi. Il contributo della fase pancreatica alla confidenza diagnostica era maggiore.

Conclusioni

Nella nostra esperienza la fase pancreatica può sostituire quella arteriosa nella valutazione di tumori endocrini pancreatici.

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Authors and Affiliations

  1. Department of Radiology, Vita-Salute University, San Raffaele Hospital, Via Olgettina 60, I-20132, Milan, Italy

    S. Gusmini, R. Nicoletti, C. Martinenghi, C. Caborni, F. De Cobelli & A. Del Maschio

  2. Department of Surgery, Vita-Salute University, San Raffaele Hospital, Via Olgettina 60, I-20132, Milan, Italy

    G. Balzano, A. Zerbi, S. I. Rocchetti & V. Di Carlo

  3. Department of Gastroenterology, Vita-Salute University, San Raffaele Hospital, Via Olgettina 60, I-20132, Milan, Italy

    P. G. Arcidiacono

  4. Department of Pathology, Vita-Salute University, San Raffaele Hospital, Via Olgettina 60, I-20132, Milan, Italy

    L. Albarello

Authors
  1. S. Gusmini
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  2. R. Nicoletti
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  3. C. Martinenghi
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  4. C. Caborni
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  5. G. Balzano
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  6. A. Zerbi
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  7. S. I. Rocchetti
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  8. P. G. Arcidiacono
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  9. L. Albarello
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  10. F. De Cobelli
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  11. V. Di Carlo
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  12. A. Del Maschio
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Correspondence to S. Gusmini.

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Gusmini, S., Nicoletti, R., Martinenghi, C. et al. Arterial vs pancreatic phase: which is the best choice in the evaluation of pancreatic endocrine tumours with multidetector computed tomography (MDCT)?. Radiol med 112, 999–1012 (2007). https://doi.org/10.1007/s11547-007-0201-1

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  • DOI: https://doi.org/10.1007/s11547-007-0201-1

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