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Prediction of recurrence after surgery based on preoperative MRI features in patients with pancreatic neuroendocrine tumors

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

Abstract

Objectives

To investigate useful MRI features in pancreatic neuroendocrine tumor (PNET) patients for predicting recurrence and its timing after surgery.

Methods

A total of 99 patients with PNET who underwent MRI and surgery from 2000 to 2018 were enrolled. Two radiologists independently assessed MRI findings, including size, location, margin, T1 and T2 signal intensity, enhancement patterns, common bile duct (CBD) or main pancreatic duct (MPD) dilatation, vascular invasion, lymph node enlargement, DWI, and ADC value. Imaging findings associated with recurrence and disease-free survival (DFS) were assessed using logistic regression analysis and Cox proportional hazard regression analysis.

Results

The median follow-up period was 40.4 months, and recurrence after surgery occurred in 12.1% (12/99). Among them, 6 patients experienced recurrence within 1 year, and 9 patients experienced recurrence within 2 years after surgery. In multivariate analysis, major venous invasion (OR 10.76 [1.14–101.85], p = 0.04) was associated with recurrence within 1 year, and portal phase iso- to hypoenhancement (OR 51.89 [1.73–1557.89], p = 0.02), CBD or MPD dilatation (OR 10.49 [1.35–81.64], p = 0.03) and larger size (OR 1.05 [1.00–1.10], p = 0.046) were associated with recurrence within 2 years. The mean DFS was 116.4 ± 18.5 months, and the 5-year DFS rate was 85.7%. In multivariate analysis, portal phase iso- to hypoenhancement (HR 21.36 [2.01–197.77], p = 0.01), ductal dilatation (HR 5.22 [1.46–18.68], p = 0.01), major arterial invasion (HR 42.90 [3.66–502.48], p = 0.003), and larger size (HR 1.04 [1.01–1.06], p = 0.01) showed a significant effect on poor DFS.

Conclusion

MRI features, including size, enhancement pattern, vascular invasion, and ductal dilatation, are useful in predicting recurrence and poor DFS after surgery in PNET.

Key Points

• MRI features are useful for predicting prognosis in patients with PNET after surgery.

• PV or SMV invasion (OR 10.49 [1.35–81.64], p = 0.04) was significantly associated with 1-year recurrence.

• Portal phase iso- to hypoenhancement (HR 21.36), CBD or MPD dilatation (HR 5.22), arterial invasion (HR 42.90), and larger size (HR 1.04) had significant effects on poor DFS (p < 0.05).

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Abbreviations

CA:

Celiac axis

CBD:

Common bile duct

CI:

Confidence interval

DFS:

Disease-free survival

HR:

Hazard ratio

LN:

Lymph node

MPD:

Main pancreatic duct

OR:

Odds ratio

PNET:

Pancreatic neuroendocrine tumor

PV:

Portal vein

SMA:

Superior mesenteric artery

SMV:

Superior mesenteric vein

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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, Seoul National University Hospital, Seoul, Republic of Korea

    Seungchul Han, Jung Hoon Kim, Jeongin Yoo & Siwon Jang

  2. Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Seungchul Han, Jung Hoon Kim, Jeongin Yoo & Siwon Jang

  3. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea

    Jung Hoon Kim

  4. Department of Radiology, Seoul National University Boramae Hospital, Seoul, Republic of Korea

    Siwon Jang

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  1. Seungchul Han
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Correspondence to Jung Hoon Kim.

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Guarantor

The scientific guarantor of this publication is Jung Hoon Kim, M.D.

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

Seungchul Han M.D. has significant statistical expertise, and no complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board. This study was approved by our Institutional Review Board, and informed patient consent was waived due to the retrospective nature of our study.

Ethical approval

Institutional Review Board approval was obtained (IRB; No. 1808–146-967).

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Han, S., Kim, J.H., Yoo, J. et al. Prediction of recurrence after surgery based on preoperative MRI features in patients with pancreatic neuroendocrine tumors. Eur Radiol 32, 2506–2517 (2022). https://doi.org/10.1007/s00330-021-08316-8

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  • DOI: https://doi.org/10.1007/s00330-021-08316-8

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