Differentiation of pancreatic neuroendocrine tumors from pancreas renal cell carcinoma metastases on CT using qualitative and quantitative features

Purpose To assess qualitative and quantitative imaging features on enhanced CT that may differentiate pancreatic neuroendocrine tumors (PNETs) from pancreatic renal cell carcinoma (RCC) metastases. Methods This IRB-approved multi-center retrospective case–control study compared 43 resected PNETs and...

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Bibliographic Details
Published in:Abdominal imaging 2019-03, Vol.44 (3), p.992-999
Main Authors: van der Pol, Christian B., Lee, Stefanie, Tsai, Scott, Larocque, Natasha, Alayed, Abdullah, Williams, Phillip, Schieda, Nicola
Format: Article
Language:English
Subjects:
Attenuation
Calcification
Carcinoma, Renal Cell - pathology
CARCINOMAS
Case-Control Studies
Chi-square test
Composition
Computed tomography
COMPUTERIZED TOMOGRAPHY
Data processing
DIAGNOSIS
Diagnosis, Differential
Dilation
ENTROPY
Evaluation Studies as Topic
Female
Gastroenterology
Hepatology
Homogeneity
Humans
Imaging
Kidney cancer
Kidney Neoplasms - pathology
KIDNEYS
Male
Medicine
Medicine & Public Health
METASTASES
Metastasis
Middle Aged
MULTIPLICITY
Neuroendocrine tumors
Neuroendocrine Tumors - diagnostic imaging
Neuroendocrine Tumors - secondary
PANCREAS
Pancreas - diagnostic imaging
Pancreatic cancer
Pancreatic carcinoma
Pancreatic Neoplasms - diagnostic imaging
Pancreatic Neoplasms - secondary
Radiology
RADIOLOGY AND NUCLEAR MEDICINE
Regression analysis
Renal cell carcinoma
Retrospective Studies
Sensitivity and Specificity
Texture
Tomography, X-Ray Computed - methods
Tumors
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Summary:Purpose To assess qualitative and quantitative imaging features on enhanced CT that may differentiate pancreatic neuroendocrine tumors (PNETs) from pancreatic renal cell carcinoma (RCC) metastases. Methods This IRB-approved multi-center retrospective case–control study compared 43 resected PNETs and 28 resected RCC metastases with pre-operative enhanced CT identified consecutively between 2003 and 2017. Two blinded radiologists (R1/R2) independently assessed tumor location, attenuation (relative to pancreas), composition (solid/cystic/mixed), homogeneity (homogeneous/heterogeneous), calcification, multiplicity, and for main pancreatic duct (MPD) dilation. Tumors were segmented for quantitative texture analysis. Data were analyzed with Chi square, logistic regression, and receiver operating characteristic (ROC). Inter-observer agreement was assessed (Cohen’s kappa). Results There was no difference in age, gender, location, attenuation, or composition ( P  > 0.05) between groups. PNETs were larger than RCC metastases (37 ± 23 mm vs. 26 ± 21 mm, P  = 0.038), more frequently solitary ( P   0.05). Entropy had ROC area under the curve for diagnosis of PNET of 0.77 ± 0.06, with optimal sensitivity/specificity of 71.4/79.1%. Conclusions Compared to pancreatic RCC metastases, PNETs are larger, more frequently solitary, contain calcification, show MPD dilation, and are subjectively and quantitatively more heterogeneous tumors.
ISSN:2366-004X
2366-0058
2366-0058
DOI:10.1007/s00261-018-01889-x