Predictive prognostic value of local and distant recurrence of F-fluorodeoxyglucose positron emission tomography for pancreatic neuroendocrine tumors with reference to World Health Organization classifications (2004, 2010). Case series study

Durán, Hipólito; Ielpo, Benedetto; Dı́az, Eduardo; Fabra, Isabel; Caruso, Riccardo; Malavé, L.; Cano-Valderrama, Óscar; Garcia, Lina; Quijano, Yolanda; Vicente, Emilio

doi:10.1016/j.ijsu.2016.03.069

Cited by 7 publications

(12 citation statements)

References 21 publications

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“…Recent studies have focused on the assessment of imaging markers for the prediction of pNET aggressiveness, including tumour conspicuity in contrast-enhanced CT images, CT perfusion parameters, apparent diffusion coefficient (ADC) values on magnetic resonance imaging (MRI) images, and radionuclide uptake on positron-emission tomography (PET). 14–16 In the present study, the post-contrast CT images of pNETs were reviewed retrospectively with the aim of evaluating whether imaging features at CT can be used to differentiate between tumour grades. Additional histological examinations (the quantification of intratumoural microvessels and stroma) were also performed to explain the findings at CT. A diagnostic algorithm is proposed for the preoperative prediction of tumour grade.…”

Section: Introductionmentioning

confidence: 99%

Contrast-enhanced MDCT in patients with pancreatic neuroendocrine tumours: correlation with histological findings and diagnostic performance in differentiation between tumour grades

Belousova

Kаrmаzаnovsky

Kriger³

et al. 2017

Clinical Radiology

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AIM To identify the multidetector computed tomography (MDCT) features of pancreatic neuroendocrine tumours (pNETs), which correlate with tumour histology and enable preoperative grading. MATERIALS AND METHODS Thirty-nine patients with histologically confirmed pNET who underwent preoperative contrast-enhanced MDCT were included in this study. Nineteen tumours were classified as Grade 1 (G1) and 20 as Grade 2 (G2). Histopathology slides were reviewed to assess the intratumoural microvascular density (MVD) and the amount of tumour stroma. Computed tomography (CT) image analysis included tumour size, margin delineation, calcifications, homogeneity, contrast enhancement (CE) pattern, tumour absolute and relative enhancement, presence of cystic changes, pancreatic duct dilatation, regional and distant metastases. The diagnostic ability to predict tumour grade was measured for each MDCT finding and their combinations. RESULTS The mean arterial enhancement ratio had a mean±standard deviation of 1.53±0.45 in G1 and 1.01±0.33 in G2 pNETs (p=0.0003) and correlated with intratumoural microvascular density (MVD; r=0.55, p=0.0002). Tissue stroma percentage did not correlate with imaging findings. Late CE of the tumour (the peak attenuation observed in the venous phase) was significantly associated with G2. Tumour size ≥20 mm, arterial enhancement ratio <1.1, and late CE showed 74.4%, 79.5%, and 74.4% accuracy, respectively, in diagnosing G2 tumours, while the accuracy of at least two of these criteria used in combination was 82%. Based on these results, a diagnostic algorithm was proposed, which showed high interobserver agreement (k=0.82) in the prediction of tumour grade. CONCLUSION Contrast-enhanced MDCT features correlate with histological findings and enable the differentiation between G1 and G2 pNETs during preoperative examination.

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Section: Introductionmentioning

confidence: 99%

Contrast-enhanced MDCT in patients with pancreatic neuroendocrine tumours: correlation with histological findings and diagnostic performance in differentiation between tumour grades

Belousova

Kаrmаzаnovsky

Kriger³

et al. 2017

Clinical Radiology

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“…High-grade NENs, which typically have low SSTR expression, are better imaged with 18 F-FDG PET than with 68 Ga-SSTR PET 7 . In addition, a growing body of evidence suggests that 18 F-FDG PET provides prognostic information for NENs, 8–30 as in other malignancies 31–33 . Prognostication with 18 F-FDG PET also has advantages of noninvasiveness and comprehensive assessment of the entire tumor.…”

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confidence: 99%

Prognostic Value of 18F-FDG PET in Neuroendocrine Neoplasm

et al. 2021

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Objectives Accurate assessment of the prognosis is critical for the rational treatment of neuroendocrine neoplasms (NENs). We performed a systematic review and meta-analysis of the prognostic value of 18F-FDG PET for NENs. Patients and Methods PubMed and Embase databases were searched up to September 2020 for studies that evaluated 18F-FDG PET as prognostic factors in patients with NENs with overall survival (OS) and event-free survival (EFS) as outcomes. Hazards ratios (HRs) comparing high and low FDG uptakes were pooled using the DerSimonian-Laird method. Publication bias was assessed and adjusted for using the trim-and-fill method. Metaregression and subgroup analyses were performed to explore the cause of heterogeneity. Results Twenty-three studies (1799 patients) were included. The overall pooled HRs of high FDG uptake on EFS and OS were 2.84 (95% confidence interval [CI], 2.21–3.64) and 3.50 (95% CI, 2.42–4.12), respectively. Publication biases were present regarding both EFS and OS (P = 0.0342 and 0.0009, respectively). After adjustment, effect sizes remained significant for EFS and OS (adjusted HR, 2.26 [95% CI, 1.76–2.89]; 3.16 [95% CI, 2.42–4.12]). In metaregression analyses, the proportion of grade 3 tumors positively correlated with the HR of OS (adjusted P = 0.0422). Conclusions 18F-FDG PET is a significant prognostic factor in patients with NENs. 18F-FDG PET might be a useful prognostic biomarker in conjunction with the histologic grade and can help select the optimal treatment.

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“…Sensitivity with panNETs only : 2017 [(68%%)[23],(58%)[147],(60%)[282]; 2016 [(65%)[296]; 2014 [(73%)[285]…”

Section: Figurementioning

confidence: 99%

“…Sensitivity with panNETs only : G1 (28%) [296], (20%) [282], (45%) [285]; G2 (83%) [296], (33%) [285],(76%) [282]; G3 (75%) [121],(88%) [285]…”

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Imaging of pancreatic neuroendocrine tumors: recent advances, current status, and controversies

Lee

Ito

Jensen

2018

Expert Review of Anticancer Therapy

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Recently, there have been a number of advances in imaging pancreatic neuroendocrine tumors (panNETs), as well as other neuroendocrine tumors (NETs), which have had a profound effect on the management and treatment of these patients, but in some cases are also associated with controversies. Areas covered: These advances are the result of numerous studies attempting to better define the roles of both cross-sectional imaging, endoscopic ultrasound, with or without fine-needle aspiration, and molecular imaging in both sporadic and inherited panNET syndromes; the increased attempt to develop imaging parameters that correlate with tumor classification or have prognostic value; the rapidly increasing use of molecular imaging in these tumors and the attempt to develop imaging parameters that correlate with treatment/outcome results. Each of these areas and the associated controversies are reviewed. Expert commentary: There have been numerous advances in all aspects of the imaging of panNETs, as well as other NETs, in the last few years. The advances are leading to expanded roles of imaging in the management of these patients and the results being seen in panNETs/GI-NETs with these newer techniques are already being used in more common tumors.

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Predictive prognostic value of local and distant recurrence of F-fluorodeoxyglucose positron emission tomography for pancreatic neuroendocrine tumors with reference to World Health Organization classifications (2004, 2010). Case series study

Abstract: FDG-PET provides a good prognostic value for PNETs. Present results must be further validated with larger sample studies.

Cited by 7 publications

References 21 publications

Contrast-enhanced MDCT in patients with pancreatic neuroendocrine tumours: correlation with histological findings and diagnostic performance in differentiation between tumour grades

Contrast-enhanced MDCT in patients with pancreatic neuroendocrine tumours: correlation with histological findings and diagnostic performance in differentiation between tumour grades

Prognostic Value of 18F-FDG PET in Neuroendocrine Neoplasm

Imaging of pancreatic neuroendocrine tumors: recent advances, current status, and controversies

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