De Robertis Riccardo, Cingarlini Sara, Tinazzi Martini Paolo, Ortolani Silvia, Butturini Giovanni, Landoni Luca, Regi Paolo, Girelli Roberto, Capelli Paola, Gobbo Stefano, Tortora Giampaolo, Scarpa Aldo, Pederzoli Paolo, D'Onofrio Mirko
Riccardo De Robertis, Department of Radiology, Casa di Cura Pederzoli, 37019 Peschiera del Garda, Italy.
World J Gastroenterol. 2017 Jan 14;23(2):275-285. doi: 10.3748/wjg.v23.i2.275.
To describe magnetic resonance (MR) imaging features of pancreatic neuroendocrine neoplasms (PanNENs) according to their grade and tumor-nodes-metastases stage by comparing them to histopathology and to determine the accuracy of MR imaging features in predicting their biological behavior.
This study was approved by our institutional review board; requirement for informed patient consent was waived due to the retrospective nature of the study. Preoperative MR examinations of 55 PanNEN patients (29 men, 26 women; mean age of 57.6 years, range 21-83 years) performed between June 2013 and December 2015 were reviewed. Qualitative and quantitative features were compared between tumor grades and stages determined by histopathological analysis.
Ill defined margins were more common in G2-3 and stage III-IV PanNENs than in G1 and low-stage tumors ( < 0.001); this feature had high specificity in the identification of G2-3 and stage III-IV tumors (90.3% and 96%, 95%CI: 73.1-97.5 and 77.7-99.8). The mean apparent diffusion coefficient value was significantly lower in G2-3 and stage III-IV lesions compared to well differentiated and low-stage tumors (1.09 × 10 mm/s 1.45 × 10 mm/s and 1.10 × 10 mm/s 1.53 × 10 mm/s, = 0.003 and 0.001). Receiving operator characteristic analysis determined optimal cut-offs of 1.21 and 1.28 × 10 mm/s for the identification of G2-3 and stage III-IV tumors, with sensitivity and specificity values of 70.8/80.7% and 64.5/64% (95%CI: 48.7-86.6/60-92.7 and 45.4-80.2/42.6-81.3).
MR features of PanNENs vary according to their grade of differentiation and their stage at diagnosis and could predict the biological behavior of these tumors.
通过将胰腺神经内分泌肿瘤（PanNENs）与组织病理学进行比较，描述其根据分级和肿瘤-淋巴结-转移分期的磁共振（MR）成像特征，并确定MR成像特征预测其生物学行为的准确性。
本研究经机构审查委员会批准；由于研究的回顾性性质，无需患者知情同意。回顾了2013年6月至2015年12月期间对55例PanNEN患者（29例男性，26例女性；平均年龄57.6岁，范围21-83岁）进行的术前MR检查。比较了组织病理学分析确定的肿瘤分级和分期之间的定性和定量特征。
边界不清在G2-3级和III-IV期PanNENs中比在G1级和低分期肿瘤中更常见（<0.001）；该特征在识别G2-3级和III-IV期肿瘤方面具有高特异性（90.3%和96%，95%CI：73.1-97.5和77.7-99.8）。与高分化和低分期肿瘤相比，G2-3级和III-IV期病变的平均表观扩散系数值显著更低（1.09×10⁻³mm²/s对1.45×10⁻³mm²/s和1.10×10⁻³mm²/s对1.53×10⁻³mm²/s，P=0.003和0.001）。接受者操作特征分析确定识别G2-3级和III-IV期肿瘤的最佳截断值分别为1.21和1.28×10⁻³mm²/s，敏感性和特异性值分别为70.8/80.7%和64.5/64%（95%CI：48.7-86.6/60-92.7和45.4-80.2/42.6-81.3）。
PanNENs的MR特征根据其分化程度和诊断时的分期而有所不同，并且可以预测这些肿瘤的生物学行为。
