Skip to main content
SpringerLink
Log in

Pancreatic neuroendocrine tumors: correlation between histogram analysis of apparent diffusion coefficient maps and tumor grade

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Abstract

Purpose

To explore the role of histogram analysis of apparent diffusion coefficient (ADC) MRI maps based on entire tumor volume data in determining pancreatic neuroendocrine tumor (PNT) grade.

Methods and Materials

Retrospective evaluation of 22 patients with PNTs included low-grade (G1; n = 15), intermediate-grade (G2; n = 4), and high-grade (G3; n = 3) tumors. Regions of interest containing the lesion were drawn on every section of the ADC map containing the tumor and summated to obtain histograms for entire tumor volume. Calculated histographic parameters included mean ADC (mADC), 5th percentile ADC, 10th percentile ADC, 25th percentile ADC, 50th percentile ADC, 75th percentile ADC (ADC75), 90th percentile ADC (ADC90) and 95th percentile ADC (ADC95), skewness and kurtosis. Histogram parameters were correlated with tumor grade by repeated measures analysis of variance with Tukey–Kramer post hoc comparisons.

Results

The mADC, ADC75, ADC90, and ADC95 were significantly higher in G1 tumors (1283 ± 267; 1404 ± 300; 1495 ± 318; 1562 ± 347 × 10−6 mm2/s) compared to G2 (892 ± 390; 952 ± 381; 1036 ± 384; 1072 ± 374 × 10−6 mm2/s) and to G3 tumors (733 ± 225; 864 ± 284; 1008 ± 288; 1152 ± 192 × 10−6 mm2/s) (p value <0.05). Skewness and kurtosis were significantly different between G1 (0.041 ± 0.466; 2.802 ± 0.679) and G3 (1.01 ± 1.140; 5.963 ± 4.008) tumors (p value <0.05). Tumor volume (mL) was significantly higher on G3 (55 ± 15.7) compared to G1 (1.9 ± 2.7) and G2 (4.5 ± 3.6) tumors (p value <0.05). In this small sample size, we did not detect statistically significant parameters between G2 (n = 4) and G3 (n = 3) tumors.

Conclusions

Histographic analysis of ADC maps on the basis of the entire tumor volume can be useful in differentiating histologic grades of PNTs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Zhou C, Zhang J, Zheng Y, Zhu Z (2012) Pancreatic neuroendocrine tumors: a comprehensive review. Int J Cancer 131(5):1013–1022

    Article  CAS  PubMed  Google Scholar 

  2. Fraenkel M, Kim MK, Faggiano A, Valk GD (2012) Epidemiology of gastroenteropancreatic neuroendocrine tumours. Best Pract Res Clin Gastroenterol 26(6):691–703

    Article  CAS  PubMed  Google Scholar 

  3. Turaga KK, Kvols LK (2011) Recent progress in the understanding, diagnosis, and treatment of gastroenteropancreatic neuroendocrine tumors. CA Cancer J Clin 61(2):113–132

    Article  PubMed  Google Scholar 

  4. Piani C, Franchi GM, Cappelletti C, et al. (2008) Cytological Ki-67 in pancreatic endocrine tumours: an opportunity for pre-operative grading. Endocr Relat Cancer 15(1):175–181

    Article  PubMed  Google Scholar 

  5. Reid MD, Balci S, Saka B, Adsay NV (2014) Neuroendocrine tumors of the pancreas: current concepts and controversies. Endocr Pathol 25(1):65–79

    Article  CAS  PubMed  Google Scholar 

  6. Plockinger U, Rindi G, Arnold R, et al. (2004) Guidelines for the diagnosis and treatment of neuroendocrine gastrointestinal tumours. A consensus statement on behalf of the European Neuroendocrine Tumour Society (ENETS). Neuroendocrinology 80(6):394–424

    Article  CAS  PubMed  Google Scholar 

  7. Oberg K, Kvols L, Caplin M, et al. (2004) Consensus report on the use of somatostatin analogs for the management of neuroendocrine tumors of the gastroenteropancreatic system. Ann Oncol 15(6):966–973

    Article  CAS  PubMed  Google Scholar 

  8. Pape UF, Jann H, Muller-Nordhorn J, et al. (2008) Prognostic relevance of a novel TNM classification system for upper gastroenteropancreatic neuroendocrine tumors. Cancer 113(2):256–265

    Article  PubMed  Google Scholar 

  9. Yamaguchi T, Fujimori T, Tomita S, et al. (2013) Clinical validation of the gastrointestinal NET grading system: Ki67 index criteria of the WHO 2010 classification is appropriate to predict metastasis or recurrence. Diagn Pathol 8:65

    Article  PubMed Central  PubMed  Google Scholar 

  10. Ramage JK, Ahmed A, Ardill J, et al. (2012) Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut 61(1):6–32

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Schmid-Tannwald C, Oto A, Reiser MF, Zech CJ (2013) Diffusion-weighted MRI of the abdomen: current value in clinical routine. J Magn Reson Imaging 37(1):35–47

    Article  PubMed  Google Scholar 

  12. Bakir B, Salmaslioglu A, Poyanli A, Rozanes I, Acunas B (2010) Diffusion weighted MR imaging of pancreatic islet cell tumors. Eur J Radiol 74(1):214–220

    Article  PubMed  Google Scholar 

  13. Wang Y, Chen ZE, Yaghmai V, et al. (2011) Diffusion-weighted MR imaging in pancreatic endocrine tumors correlated with histopathologic characteristics. J Magn Reson Imaging 33(5):1071–1079

    Article  PubMed  Google Scholar 

  14. Bull JG, Saunders DE, Clark CA (2012) Discrimination of paediatric brain tumours using apparent diffusion coefficient histograms. Eur Radiol 22(2):447–457

    Article  PubMed  Google Scholar 

  15. Kang Y, Choi SH, Kim YJ, et al. (2011) Gliomas: Histogram analysis of apparent diffusion coefficient maps with standard- or high-b-value diffusion-weighted MR imaging—correlation with tumor grade. Radiology 261(3):882–890

    Article  PubMed  Google Scholar 

  16. Ahn SJ, Choi SH, Kim YJ, et al. (2012) Histogram analysis of apparent diffusion coefficient map of standard and high B-value diffusion MR imaging in head and neck squamous cell carcinoma: a correlation study with histological grade. Acad Radiol 19(10):1233–1240

    Article  PubMed  Google Scholar 

  17. Hayashida Y, Hirai T, Morishita S, et al. (2006) Diffusion-weighted imaging of metastatic brain tumors: comparison with histologic type and tumor cellularity. AJNR Am J Neuroradiol 27(7):1419–1425

    CAS  PubMed  Google Scholar 

  18. Heo SH, Shin SS, Kim JW, et al. (2013) Pre-treatment diffusion-weighted MR imaging for predicting tumor recurrence in uterine cervical cancer treated with concurrent chemoradiation: value of histogram analysis of apparent diffusion coefficients. Korean J Radiol 14(4):616–625

    Article  PubMed Central  PubMed  Google Scholar 

  19. Downey K, Riches SF, Morgan VA, et al. (2013) Relationship between imaging biomarkers of stage I cervical cancer and poor-prognosis histologic features: quantitative histogram analysis of diffusion-weighted MR images. AJR Am J Roentgenol 200(2):314–320

    Article  PubMed  Google Scholar 

  20. Brenner R, Metens T, Bali M, Demetter P, Matos C (2012) Pancreatic neuroendocrine tumor: added value of fusion of T2-weighted imaging and high b-value diffusion-weighted imaging for tumor detection. Eur J Radiol 81(5):e746–e749

    Article  PubMed  Google Scholar 

  21. Dale BM, Braithwaite AC, Boll DT, Merkle EM (2010) Field strength and diffusion encoding technique affect the apparent diffusion coefficient measurements in diffusion-weighted imaging of the abdomen. Invest Radiol 45(2):104–108

    Article  PubMed  Google Scholar 

  22. Bender R, Lange S (2001) Adjusting for multiple testing—when and how? J Clin Epidemiol 54(4):343–349

    Article  CAS  PubMed  Google Scholar 

  23. Kumar R, Indrayan A (2011) Receiver operating characteristic (ROC) curve for medical researchers. Indian Pediatr 48(4):277–287

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal

    Jose Antonio Sousa Pereira

  2. Department of Radiology, Hospital Fernando Fonseca, Amadora, Portugal

    Elsa Rosado

  3. Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium

    Maria Bali & Thierry Metens

  4. Department of Radiology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium

    Shih-Li Chao

Authors
  1. Jose Antonio Sousa Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elsa Rosado
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maria Bali
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thierry Metens
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shih-Li Chao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jose Antonio Sousa Pereira.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pereira, J.A.S., Rosado, E., Bali, M. et al. Pancreatic neuroendocrine tumors: correlation between histogram analysis of apparent diffusion coefficient maps and tumor grade. Abdom Imaging 40, 3122–3128 (2015). https://doi.org/10.1007/s00261-015-0524-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-015-0524-7

Keywords

Search

Navigation