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- Title
Prediction of pancreatic neuroendocrine tumour grade with MR imaging features: added value of diffusion-weighted imaging.
- Authors
Lotfalizadeh, Emad; Ronot, Maxime; Wagner, Mathilde; Cros, Jérôme; Couvelard, Anne; Vullierme, Marie-Pierre; Allaham, Wassim; Hentic, Olivia; Ruzniewski, Philippe; Vilgrain, Valérie
- Abstract
<bold>Objectives: </bold>To evaluate the value of MR imaging including diffusion-weighted imaging (DWI) for the grading of pancreatic neuroendocrine tumours (pNET).<bold>Material and Methods: </bold>Between 2006 and 2014, all resected pNETs with preoperative MR imaging including DWI were included. Tumour grading was based on the 2010 WHO classification. MR imaging features included size, T1-w, and T2-w signal intensity, enhancement pattern, apparent (ADC) and true diffusion (D) coefficients.<bold>Results: </bold>One hundred and eight pNETs (mean 40 ± 33 mm) were evaluated in 94 patients (48 women, 51 %, mean age 52 ± 12). Fifty-five (51 %), 42 (39 %), and 11 (10 %) tumours were given the following grades (G): G1, G2, and G3. Mean ADC and D values were significantly lower as grade increased (ADC: 2.13 ± 0.70, 1.78 ± 0.72, and 0.86 ± 0.22 10-3 mm2/s, and D: 1.92 ± 0.70, 1.75 ± 0.74, and 0.82 ± 0.19 10-3 mm2/s G1, G2, and G3, all p < 0.001). A higher grade was associated with larger sized tumours (p < 0.001). The AUROC of ADC and D to differentiate G3 and G1-2 were 0.96 ± 0.02 and 0.95 ± 0.02. Optimal cut-off values for the identification of G3 were 1.19 10-3 mm2/s for ADC (sensitivity 100 %, specificity 92 %) and 1.04 10-3 mm2/s for D (sensitivity 82 %, specificity 92 %).<bold>Conclusion: </bold>Morphological/functional MRI features of pNETS depend on tumour grade. DWI is useful for the identification of high-grade tumours.<bold>Key Points: </bold>• Morphological and functional MRI features of pNETs depend on tumour grade. • Their combination has a high predictive value for grade. • All pNETs should be explored by MR imaging including DWI. • DWI is helpful for identification of high-grade and poorly-differentiated tumours.
- Subjects
DIFFUSION magnetic resonance imaging; PANCREATIC diseases; TUMORS; TUMOR grading; PERFORMANCE of imaging systems; DIAGNOSIS; MAGNETIC resonance imaging; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; NEUROENDOCRINE tumors; PANCREATIC tumors; RESEARCH; EVALUATION research; RETROSPECTIVE studies
- Publication
European Radiology, 2017, Vol 27, Issue 4, p1748
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-016-4539-4