Comparison of imaging-based and pathological dimensions in pancreatic neuroendocrine tumors

World J Gastroenterol. 2017 May 7;23(17):3092-3098. doi: 10.3748/wjg.v23.i17.3092.

Abstract

Aim: 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.

Methods: 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.

Results: 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 (P = 0.433). PBR analysis did not reveal significant differences between MR, CT and pathology.

Conclusion: MR and CT scan are accurate and interchangeable imaging techniques in predicting pathologic dimensions of PanNET.

Keywords: Diagnostic imaging; Magnetic resonance imaging; Neuroendocrine tumors; Pancreatic neoplasms; Pathological dimensions.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Feasibility Studies
  • Female
  • Humans
  • Intestinal Neoplasms / diagnostic imaging*
  • Intestinal Neoplasms / pathology*
  • Intestinal Neoplasms / surgery
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / diagnostic imaging*
  • Neuroendocrine Tumors / pathology*
  • Neuroendocrine Tumors / surgery
  • Pancreas / diagnostic imaging
  • Pancreas / pathology
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery
  • Prospective Studies
  • Retrospective Studies
  • Stomach Neoplasms / diagnostic imaging*
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery
  • Tertiary Care Centers / statistics & numerical data
  • Tomography, X-Ray Computed

Supplementary concepts

  • Gastro-enteropancreatic neuroendocrine tumor
  • Non functioning pancreatic endocrine tumor