Paiella Salvatore, Impellizzeri Harmony, Zanolin Elisabetta, Marchegiani Giovanni, Miotto Marco, Malpaga Anna, De Robertis Riccardo, D'Onofrio Mirko, Rusev Borislav, Capelli Paola, Cingarlini Sara, Butturini Giovanni, Davì Maria Vittoria, Amodio Antonio, Bassi Claudio, Scarpa Aldo, Salvia Roberto, Landoni Luca
Salvatore Paiella, Harmony Impellizzeri, Giovanni Marchegiani, Marco Miotto, Anna Malpaga, Claudio Bassi, Roberto Salvia, Luca Landoni, General and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, 37134 Verona, Italy.
World J Gastroenterol. 2017 May 7;23(17):3092-3098. doi: 10.3748/wjg.v23.i17.3092.
To establish the ability of magnetic resonance (MR) and computer tomography (CT) to predict pathologic dimensions of pancreatic neuroendocrine tumors (PanNET) in a caseload of a tertiary referral center.
Patients submitted to surgery for PanNET at the Surgical Unit of the Pancreas Institute with at least 1 preoperative imaging examination (MR or CT scan) from January 2005 to December 2015 were included and data retrospectively collected. Exclusion criteria were: multifocal lesions, genetic syndromes, microadenomas or mixed tumors, metastatic disease and neoadjuvant therapy. Bland-Altman (BA) and Mountain-Plot (MP) statistics were used to compare size measured by each modality with the pathology size. Passing-Bablok (PB) regression analysis was used to check the agreement between MR and CT.
Our study population consisted of 292 patients. Seventy-nine (27.1%) were functioning PanNET. The mean biases were 0.17 ± 7.99 mm, 1 ± 8.51 mm and 0.23 ± 9 mm, 1.2 ± 9.8 mm for MR and CT, considering the overall population and the subgroup of non-functioning- PanNET, respectively. Limits of agreement (LOA) included the vast majority of observations, indicating a good agreement between imaging and pathology. The MP further confirmed this finding and showed that the two methods are unbiased with respect to each other. Considering ≤ 2 cm non-functioning-PanNET, no statistical significance was found in the size estimation rate of MR and CT ( = 0.433). PBR analysis did not reveal significant differences between MR, CT and pathology.
MR and CT scan are accurate and interchangeable imaging techniques in predicting pathologic dimensions of PanNET.
在一家三级转诊中心的病例中，确定磁共振成像（MR）和计算机断层扫描（CT）预测胰腺神经内分泌肿瘤（PanNET）病理大小的能力。
纳入2005年1月至2015年12月期间在胰腺研究所外科接受PanNET手术且术前至少进行过1次影像学检查（MR或CT扫描）的患者，并回顾性收集数据。排除标准为：多灶性病变、遗传综合征、微腺瘤或混合瘤、转移性疾病和新辅助治疗。采用布兰德-奥特曼（BA）统计和山形图（MP）统计来比较每种检查方式测得的大小与病理大小。采用帕辛-巴布洛（PB）回归分析来检验MR和CT之间的一致性。
我们的研究队列包括292例患者。79例（27.1%）为功能性PanNET。对于总体人群和无功能性PanNET亚组，MR的平均偏差分别为0.17±7.99毫米、1±8.51毫米，CT的平均偏差分别为0.23±9毫米、1.2±9.8毫米。一致性界限（LOA）包括了绝大多数观察值，表明影像学与病理之间具有良好的一致性。MP进一步证实了这一发现，并表明这两种方法相互之间无偏差。对于直径≤2厘米的无功能性PanNET，MR和CT在大小估计率方面未发现统计学差异（P = 0.433）。PB回归分析未显示MR、CT与病理之间存在显著差异。
MR和CT扫描在预测PanNET病理大小方面是准确且可相互替代的影像学技术。
