A score derived from routine biochemical parameters increases the diagnostic accuracy of chromogranin A in detecting patients with neuroendocrine neoplasms

Kruljac, Ivan; Vurnek, Ivan; Maasberg, Sebastian; Kust, Davor; Blaslov, Kristina; Davidović, Blaženka Ladika; Štefanović, Mario; Demirović, Alma; Bišćanin, Alen; Filipović-Čugura, Jakša; Brozić, Jasmina Marić; Pape, Ulrich‐Frank; Vrkljan, Milan

doi:10.1007/s12020-018-1592-6

Cited by 3 publications

(2 citation statements)

References 42 publications

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“…The primary goal is to identify all PNETs and avoid unnecessary surgical resection of IPS [ 24 ]. Clinical symptoms are uncommon with PNETs, and biomarkers and even biopsies are often unreliable [ 16 , 47 , 48 , 50 , 51 ]. Since PNETs can be very slow growing, follow-up imaging can also be of limited value to rule out potential malignancy [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors

et al. 2020

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Objectives Ferumoxytol is an ultra-small superparamagnetic iron oxide (USPIO) agent that is taken up by splenic tissue. This study describes our initial institutional experience of ferumoxytol-enhanced MRI (feMRI) for differentiating intrapancreatic splenules (IPS) from other pancreatic lesions. Methods In this retrospective study, patients with computed tomographic imaging that identified small enhancing lesions in the tail of the pancreas subsequently underwent feMRI for further characterization. The feMRI protocol included T2-weighted (T2w) imaging with and without fat suppression (FS), R2* mapping, diffusion-weighted imaging (DWI), and T1-weighted (T1w) imaging with FS, prior to contrast injection. Immediately after slow intravenous infusion with 3 mg/kg body weight ferumoxytol, T1w was repeated. Delayed imaging with all sequences were obtained 24–72 h after ferumoxytol administration. Results Seven patients underwent feMRI. In two patients, the pancreatic lesions were presumed as pancreatic neuroendocrine tumor (PNET) from feMRI and in the remaining 5 IPS. One of the two patients with PNET was symptomatic for NET. In another symptomatic patient with pathologically proven duodenal NET and suspected PNET, the pancreatic lesion was proven to be an IPS on feMRI. IPS demonstrated strong negative enhancement in feMRI on T2w and increased R2* values consistent with splenic tissue, while the presumed PNETs did not enhance. T2w FS was helpful on the pre-contrast images to identify IPS, while R2* did on post-contrast images. Neither DWI nor T1w contributed to differentiating PNETs from IPS. Conclusions This study demonstrates the potential utility of feMRI as a helpful adjunct diagnostic tool for differentiating IPS from other pancreatic lesions. Further studies in larger patient cohorts are needed.

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Section: Discussionmentioning

confidence: 99%

Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors

et al. 2020

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“…With a clearer understanding of the tumors and a precise histologic definition [2], the reported crude incidence has risen worldwide and is now approximately 3.5/100.000 [3]. While small intestinal (SI) NEN used to be detected much more frequently than pancreatic (p) NEN, more recently, the diagnosis of pNEN has been almost as frequent as SI-NEN [3,4]. National and international consensus guidelines for the management of GEP-NEN recommend surgery for most patients [5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Complications of surgery for gastro-entero-pancreatic neuroendocrine neoplasias

Albers

Almquist

Bergenfelz

et al. 2020

Langenbecks Arch Surg

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Purpose Surgery is recommended for most patients with gastro-entero-pancreatic neuroendocrine neoplasias (GEP-NENs). Rates of complications and perioperative mortality have been reported in few mostly retrospective single-center series, but there has been no detailed analysis on risk factors for perioperative complications and mortality to date. Methods Data of patients with GEP-NENs operated between January 2015 and September 2018 were retrieved from EUROCRINE©, a European online endocrine surgical quality registry, and analyzed regarding rate and risk factors of surgical complications. Risk factors were assessed by logistic regression. Results Some 376 patients (211 female, 167 male; age median 63, range 15-89 years) were included. Most NENs were located in the small intestine (SI) (n = 132) or pancreas (n = 111), the rest in the stomach (n = 34), duodenum (n = 30), appendix (n = 30), colon, and rectum (n = 22), or with unknown primary (n = 15). Of the tumors, 320 (85.1%) were well or moderately differentiated, and 147 (39.1%) of the patients had distant metastases at the time of operation. Severe complications (Dindo-Clavien ≥ 3) occurred in 56 (14.9%) patients, and 4 (1.1%) patients died perioperatively. Severe complications were more frequent in surgery for duodenopancreatic NENs (n = 31; 22.0%) compared with SI-NENs (n = 15; 11.4%) (p = 0.014), in patients with lymph node metastases operated with curative aim of surgery (n = 24; 21.4%) versus non-metastasized tumors or palliative surgery (n = 32; 12.1%) (p = 0.020), and in functioning tumors (n = 20; 23.0%) versus non-functioning tumors (n = 30; 13.5%) (p = 0.042). Complication rates were not significantly associated with tumor stage or grade. Conclusions Severe complications are frequent in GEP-NEN surgery. Besides duodenopancreatic tumor location, curative resection of nodal metastases and functioning tumors are risk factors for complications.

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Survival comparison between primary hepatic neuroendocrine neoplasms and primary pancreatic neuroendocrine neoplasms and the analysis on prognosis-related factors

Xiao

et al. 2019

Hepatobiliary & Pancreatic Diseases International

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A score derived from routine biochemical parameters increases the diagnostic accuracy of chromogranin A in detecting patients with neuroendocrine neoplasms

Abstract: CgA-score encompasses a wide range of comorbidities and represents a promising tool that could improve diagnostic performance of CgA in everyday clinical practice.

Cited by 3 publications

References 42 publications

Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors

Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors

Complications of surgery for gastro-entero-pancreatic neuroendocrine neoplasias

Survival comparison between primary hepatic neuroendocrine neoplasms and primary pancreatic neuroendocrine neoplasms and the analysis on prognosis-related factors

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