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Differential diagnosis of pancreatoblastoma (PB) and solid pseudopapillary neoplasms (SPNs) in children by CT and MR imaging

  • Paediatric
  • Published:
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Abstract

Objectives

To determine whether features on computed tomographic and/or magnetic resonance imaging can differentiate pancreatoblastoma (PB) from solid pseudopapillary neoplasms (SPNs) of the pancreas in children.

Methods

Clinical and imaging data for 20 cases of SPNs and 14 cases of PB confirmed by surgery or biopsy were retrospectively analysed. The size, border, calcification, haemorrhage, solid/cystic component proportion, intratumoural vessels, tumour capsulation, pancreatic duct dilatation, peripancreatic vessel invasion, distant metastasis status and apparent diffusion coefficient (ADC) values of the two groups were examined, and key diagnostic features were identified. Statistical analysis was performed using the chi-square test and Student’s t test. Sensitivity and specificity values were calculated when a single criterion was used.

Results

Age ≤ 5 years, elevated serum α-fetoprotein (AFP), larger size, ill-defined border, calcification, absence of haemorrhage, intratumoural vessel, peripancreatic vessel invasion and distant metastasis differentiated PB from SPN (p < 0.05). ADC values of SPN were higher than those of PB (p = 0.001). There were no significant differences regarding tumour capsule (p = 0.435), pancreatic duct dilatation (p = 1.000) or cystic degeneration area over 50% of the tumour volume (p = 1.000) between the two groups.

Conclusions

The following features are helpful for differentiating PB from SPN: age ≤ 5 years, elevated serum AFP, larger size, ill-defined border, calcification, haemorrhage absence, intratumoural vessel, peripancreatic vessel invasion, distant metastasis and lower ADC value.

Key Points

• CT and MRI are helpful to differentiate pancreatoblastoma (PB) from solid pseudopapillary neoplasms (SPNs) of the pancreas in children.

• The following features are helpful to differentiate PB from SPN: age ≤ 5 years, elevated serum AFP, larger size, ill-defined border, calcification, absence of haemorrhage, intratumoural vessel, peripancreatic vessel invasion, distant metastasis and lower ADC value.

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Abbreviations

ADC:

Apparent diffusion coefficient

AFP:

α-Fetoprotein

CT:

Computed tomography

MRI:

Magnetic resonance imaging

PB:

Pancreatoblastoma

SPNs:

Solid pseudopapillary neoplasms

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Funding

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

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Authors and Affiliations

  1. Department of Radiology, Children’s Hospital of Fudan University, 399 Wanyuan Rd., Shanghai, 200032, China

    Zhaoxia Yang, Ying Gong, Min Ji, Bin Yang & Zhongwei Qiao

Authors
  1. Zhaoxia Yang
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  2. Ying Gong
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  3. Min Ji
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  4. Bin Yang
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  5. Zhongwei Qiao
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Correspondence to Ying Gong.

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The scientific guarantor of this publication is Ying Gong.

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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.

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• retrospective

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• performed at one institution

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Yang, Z., Gong, Y., Ji, M. et al. Differential diagnosis of pancreatoblastoma (PB) and solid pseudopapillary neoplasms (SPNs) in children by CT and MR imaging. Eur Radiol 31, 2209–2217 (2021). https://doi.org/10.1007/s00330-020-07309-3

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  • DOI: https://doi.org/10.1007/s00330-020-07309-3

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