Differentiation of duodenal gastrointestinal stromal tumors from hypervascular pancreatic neuroendocrine tumors in the pancreatic head using contrast-enhanced computed tomography

Ren, Shuai; Chen, Xiao; Wang, Jianhua; Zhao, Rui; Song, Lina; Li, Hui; Wang, Zhongqiu

doi:10.1007/s00261-018-1803-x

Cited by 10 publications

(8 citation statements)

References 34 publications

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“…Ren et al23 investigated the value of CT enhancement level in differentiating duodenal gastrointestinal tumors from hypervascular pancreatic neuroendocrine tumors. Takumi et al24 assessed the value of CT contrast enhancement and tumor-to-pancreas ratio in pancreatic neuroendocrine tumors grading.…”

Section: Discussionmentioning

confidence: 99%

Differentiation of chronic mass-forming pancreatitis from pancreatic ductal adenocarcinoma using contrast-enhanced computed tomography

Ren¹,

Chen²,

Cui³

et al. 2019

CMAR

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PurposeBoth chronic mass-forming pancreatitis (CMFP) and pancreatic ductal adenocarcinoma (PDAC) are focal pancreatic lesions and share very similar clinical symptoms and imaging performance. There is great clinical value in preoperative differentiation of those two lesions. The purpose of this study was to investigate the value of computed tomography (CT) features in discriminating CMFP from PDAC.Patients and methodsForty-seven patients with pathologically confirmed PDAC and 21 patients with CMFP were included in this study. Demographic and CT features, including tumor location, size, margin, pancreatic or bile duct dilatation, vascular invasion, cystic necrosis, pancreatic atrophy, calcification, and tumor contrast enhancement, were retrospectively analyzed and compared. Multivariate logistic regression analyses were adopted to identify relevant CT imaging features to discriminate CMFP from PDAC.ResultsThere were significant differences between CMFP and PDAC with respect to main pancreatic duct dilatation, vascular invasion, cystic necrosis, pancreatic atrophy, calcification, and tumor contrast enhancement. Delayed contrast enhancement (>70.5 Hounsfield units) showed high sensitivity and specificity of 84.2% and 84.7%. The areas under the curve (AUCs) of the predicting models based on qualitative and quantitative variables were 0.770 (95% CI: 0.660–0.880) and 0.943 (95% CI: 0.888–0.999), respectively. When all significant variables were used in combination to build a predicting model, the AUC was 0.969 (95% CI: 0.930–1.000) with 84.2% sensitivity and 94.7% specificity.ConclusionMain pancreatic duct dilatation, vascular invasion, cystic necrosis, pancreatic atrophy, calcification, tumor size, and tumor contrast enhancement were shown to be useful CT imaging features in discriminating CMFP from PDAC.

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Section: Discussionmentioning

confidence: 99%

Differentiation of chronic mass-forming pancreatitis from pancreatic ductal adenocarcinoma using contrast-enhanced computed tomography

Ren¹,

Chen²,

Cui³

et al. 2019

CMAR

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“…A well-defined margin indicated a smooth and visible margin, while an ill-defined margin indicated spiculation or infiltration on >90° of the tumor parameter. Tumor texture was divided into solid (an enhancing solid component of more than 90%), predominantly solid (an enhancing solid component of 50%–90%), and predominantly cystic (an enhancing solid component of <50%) 29. Local invasion or metastases referred to extrapancreatic localizations, including vascular or lymph node invasion, spleen invasion, or liver metastases, etc.…”

Section: Methodsmentioning

confidence: 99%

Pancreatic neuroendocrine tumor: prediction of the tumor grade using magnetic resonance imaging findings and texture analysis with 3-T magnetic resonance

Guo¹,

Ren²,

Chen³

et al. 2019

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Purpose The purpose of this study was to evaluate the performance of magnetic resonance imaging (MRI) findings and texture parameters for prediction of the histopathologic grade of pancreatic neuroendocrine tumors (PNETs) with 3-T magnetic resonance. Patients and methods PNETs are classified into Grade 1 (G1), Grade 2 (G2), and Grade 3 (G3) tumors based on the Ki-67 proliferation index and the mitotic activity. A total of 77 patients with pathologically confirmed PNETs met the inclusion criteria. Texture analysis (TA) was applied to T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) maps. Patient demographics, MRI findings, and texture parameters were compared among three different histopathologic subtypes by using Fisher’s exact tests or Kruskal–Wallis test. Then, logistic regression analysis was adopted to predict tumor grades. ROC curves and AUCs were calculated to assess the diagnostic performance of MRI findings and texture parameters in prediction of tumor grades. Results There were 31 G1, 29 G2, and 17 G3 patients. Compared with G1, G2/G3 tumors showed higher frequencies of an ill-defined margin, a predominantly solid tumor type, local invasion or metastases, hypo-enhancement at the arterial phase, and restriction diffusion. Four T2-based (inverse difference moment, energy, correlation, and differenceEntropy) and five DWI-based (correlation, contrast, inverse difference moment, maxintensity, and entropy) TA parameters exhibited statistical significance among PNETs ( P <0.001). The AUCs of six predicting models on T2WI and DWI ranged from 0.703–0.989. Conclusion Our data indicate that MRI findings, including tumor margin, texture, local invasion or metastases, tumor enhancement, and diffusion restriction, as well as texture parameters can aid the prediction of PNETs grading.

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“…Важным дифференциально-диагностическим признаком является то, что ГИСО -это гиперваскулярное образование, в отличие от гиповаскулярной аденокарциномы [17]. Стоит отметить, что ГИСО ДПК важно дифференцировать с гиперваскулярной нейроэндокринной опухолью (НЭО) головки ПЖ, потому что от этого напрямую зависит хирургическая тактика [18]. КТ-признаки, отличающие ГИСО ДПК от НЭО ПЖ -более близкое расположение к ДПК, прева лирующий солидный компонент опухоли, размеры >2,75 см.…”

Section: обсуждение результатовunclassified

“…КТ-признаки, отличающие ГИСО ДПК от НЭО ПЖ -более близкое расположение к ДПК, прева лирующий солидный компонент опухоли, размеры >2,75 см. и накопление КП в артериальную фазу (30 с) ≤135 HU и ≥89,5 в отсроченную фазу (120 с) [18]. Чем больше размер ГИСО, тем менее интенсивно контрастирование в артериальную фазу и сложнее дифференциальная диагностика с гиповаскулярными новообразованиями (рис.…”

Section: обсуждение результатовunclassified

Computer-assisted and magnetic resonance imaging assessment of tumors and tumor invasion of the duodenum

Kаrmаzаnovsky

Abuladze²

2022

Ann. hir. gepatol.

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Aim: To present the computed tomography and magnetic resonance imaging assessments of benign and malignant duodenal tumors, pancreatic head adenocarcinoma invading the duodenum, and duodenal dystrophy.Methods: We searched for scientific papers and clinical guidelines in the information and analytical databases PubMed and Google Scholar from the 2013–2021 period using the following search terms: duodenal neoplasms, adenocarcinoma, duodenum, duodenal neuroendocrine tumors, duodenal adenoma, gastrointestinal stromal tumor, cholangiocarcinoma, radiology, magnetic resonance imaging, computed tomography, pancreatic head cancer. Then, we examined the reference lists of all the identified studies to collate the papers that would meet the eligibility criteria.Results: We analyzed 1494 articles, 22 of which were included in our review. From the papers published within 1992–2021, 35 articles from the reference lists were additionally included. Based on the search results, several domains of articles were clustered; the articles from those domains were reviewed and evaluated that involved the abovementioned diagnostic features.Conclusion: The early diagnosis and selection of appropriate management methods remain extremely relevant for the treatment of duodenal tumors, and hence, require careful attention from diagnosticians and clinicians.

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Differentiation of duodenal gastrointestinal stromal tumors from hypervascular pancreatic neuroendocrine tumors in the pancreatic head using contrast-enhanced computed tomography

Cited by 10 publications

References 34 publications

<p>Differentiation of chronic mass-forming pancreatitis from pancreatic ductal adenocarcinoma using contrast-enhanced computed tomography</p>

<p>Differentiation of chronic mass-forming pancreatitis from pancreatic ductal adenocarcinoma using contrast-enhanced computed tomography</p>

<p>Pancreatic neuroendocrine tumor: prediction of the tumor grade using magnetic resonance imaging findings and texture analysis with 3-T magnetic resonance</p>

Computer-assisted and magnetic resonance imaging assessment of tumors and tumor invasion of the duodenum

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