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Can histogram analysis of MR images predict aggressiveness in pancreatic neuroendocrine tumors?

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate MRI derived whole-tumour histogram analysis parameters in predicting pancreatic neuroendocrine neoplasm (panNEN) grade and aggressiveness.

Methods

Pre-operative MR of 42 consecutive patients with panNEN >1 cm were retrospectively analysed. T1-/T2-weighted images and ADC maps were analysed. Histogram-derived parameters were compared to histopathological features using the Mann-Whitney U test. Diagnostic accuracy was assessed by ROC-AUC analysis; sensitivity and specificity were assessed for each histogram parameter.

Results

ADCentropy was significantly higher in G2-3 tumours with ROC-AUC 0.757; sensitivity and specificity were 83.3 % (95 % CI: 61.2–94.5) and 61.1 % (95 % CI: 36.1–81.7). ADCkurtosis was higher in panNENs with vascular involvement, nodal and hepatic metastases (p= .008, .021 and .008; ROC-AUC= 0.820, 0.709 and 0.820); sensitivity and specificity were: 85.7/74.3 % (95 % CI: 42–99.2 /56.4–86.9), 36.8/96.5 % (95 % CI: 17.2–61.4 /76–99.8) and 100/62.8 % (95 % CI: 56.1–100/44.9–78.1). No significant differences between groups were found for other histogram-derived parameters (p >.05).

Conclusions

Whole-tumour histogram analysis of ADC maps may be helpful in predicting tumour grade, vascular involvement, nodal and liver metastases in panNENs. ADCentropy and ADCkurtosis are the most accurate parameters for identification of panNENs with malignant behaviour.

Key Points

• Whole-tumour ADC histogram analysis can predict aggressiveness in pancreatic neuroendocrine neoplasms.

• ADC entropy and kurtosis are higher in aggressive tumours.

• ADC histogram analysis can quantify tumour diffusion heterogeneity.

• Non-invasive quantification of tumour heterogeneity can provide adjunctive information for prognostication.

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Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under the curve

G1:

Grade 1

G2:

Grade 2

G3:

Grade 3

GEP-NET:

Gastroentero-pancreatic neuroendocrine tumour

panNEN:

Pancreatic neuroendocrine neoplasm

ROC:

Receiver operating characteristic

ROI:

Region of interest

WHO:

World Health Organization

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Funding

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

Author information

Authors and Affiliations

  1. Department of Radiology, P. Pederzoli Hospital, Via Monte Baldo 24, 37019, Peschiera del Garda, Italy

    Riccardo De Robertis, Nicolò Cardobi & Paolo Tinazzi Martini

  2. Department of Computer Science, University of Verona, Strada le Grazie 15, 37134, Verona, Italy

    Bogdan Maris

  3. Department of Pathology, P. Pederzoli Hospital, Via Monte Baldo 24, 37019, Peschiera del Garda, Italy

    Stefano Gobbo

  4. Department of Pathology, G.B. Rossi Hospital – University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy

    Paola Capelli & Aldo Scarpa

  5. Department of Oncology, P. Pederzoli Hospital, Via Monte Baldo 24, 37019, Peschiera del Garda, Italy

    Silvia Ortolani

  6. Department of Oncology, G.B. Rossi Hospital – University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy

    Sara Cingarlini & Giampaolo Tortora

  7. Department of Pancreatic Surgery, G.B. Rossi Hospital – University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy

    Salvatore Paiella & Luca Landoni

  8. Department of Pancreatic Surgery, P. Pederzoli Hospital, Via Monte Baldo 24, 37019, Peschiera del Garda, Italy

    Giovanni Butturini & Paolo Regi

  9. Department of Radiology, G.B. Rossi Hospital – University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy

    Mirko D’Onofrio

Authors
  1. Riccardo De Robertis
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  2. Bogdan Maris
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  3. Nicolò Cardobi
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  4. Paolo Tinazzi Martini
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  6. Paola Capelli
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  7. Silvia Ortolani
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  8. Sara Cingarlini
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  9. Salvatore Paiella
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  11. Giovanni Butturini
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  12. Paolo Regi
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  13. Aldo Scarpa
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  14. Giampaolo Tortora
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  15. Mirko D’Onofrio
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Corresponding author

Correspondence to Riccardo De Robertis.

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Guarantor

The scientific guarantor of this publication is Mirko D’Onofrio.

Conflict of interest

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.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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De Robertis, R., Maris, B., Cardobi, N. et al. Can histogram analysis of MR images predict aggressiveness in pancreatic neuroendocrine tumors?. Eur Radiol 28, 2582–2591 (2018). https://doi.org/10.1007/s00330-017-5236-7

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  • DOI: https://doi.org/10.1007/s00330-017-5236-7

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