PMID- 29075857
OWN - NLM
STAT- MEDLINE
DCOM- 20180905
LR  - 20181202
IS  - 1432-2323 (Electronic)
IS  - 0364-2313 (Linking)
VI  - 42
IP  - 5
DP  - 2018 May
TI  - Preoperative Imaging Overestimates the Tumor Size in Pancreatic Neuroendocrine 
      Neoplasms Associated with Multiple Endocrine Neoplasia Type 1.
PG  - 1440-1447
LID - 10.1007/s00268-017-4317-8 [doi]
AB  - BACKGROUND: Radiological tumor size of non-functioning pancreatic neuroendocrine 
      neoplasms (Nf-pNENs) associated with multiple endocrine neoplasia type 1 (MEN1) 
      is a crucial parameter to indicate surgery. The aim of this study was to compare 
      radiological size (RS) and pathologic size (PS) of MEN1 associated with pNENs. 
      METHODS: Prospectively collected data of MEN1 patients who underwent pancreatic 
      resections for pNENs were retrospectively analyzed. RS was defined as the largest 
      tumor diameter measured on endoscopic ultrasound (EUS), magnetic resonance 
      imaging (MRI) or computed tomography (CT). PS was defined as the largest tumor 
      diameter on pathological analysis. Student's t test and linear regression 
      analysis were used to compare the median RS and PS. p < 0.05 was considered 
      significant. RESULTS: Forty-four patients with a median age of 37 (range 10-68) 
      years underwent primary pancreatic resections for pNENs. Overall, the median RS 
      (20 mm, range 3-100 mm) was significantly larger than the PS (13 mm, range 
      4-110 mm) (p = 0.001). In patients with pNENs < 20 mm (n = 27), the size 
      difference (median RS 15 mm vs PS 12 mm) was also significant (p = 0.003). 
      However, the only modality that significantly overestimated the PS was EUS 
      (median RS 14 mm vs 11 mm; p = 0.0002). RS overestimated the PS in 21 patients 
      (21 of 27 patients, 78%). Five of 11 patients (12%) with a Nf-pNEN and a 
      RS > 20 mm had in reality a PS < 20 mm. MRI was the imaging technique that best 
      correlated with PS in the total cohort (r = 0.8; p < 0.0001), whereas EUS was the 
      best correlating imaging tool in pNENs < 20 mm (r = 0.5; p = 0.0001). CONCLUSION: 
      Preoperative imaging, especially EUS, frequently overestimates the size of 
      MEN1-pNENs, especially those with a PS < 20 mm. This should be considered when 
      indicating surgery in MEN1 patients with small Nf-pNENs.
FAU - Polenta, V
AU  - Polenta V
AD  - Department of Visceral, Thoracic and Vascular Surgery, Philipps-University 
      Marburg, Marburg, Germany. vanepolenta@gmail.com.
AD  - Department of General Surgery, Ospedali Riuniti Ancona, Conca 71, Torrette, 
      60020, Ancona, Italy. vanepolenta@gmail.com.
FAU - Slater, E P
AU  - Slater EP
AD  - Department of Visceral, Thoracic and Vascular Surgery, Philipps-University 
      Marburg, Marburg, Germany.
FAU - Kann, P H
AU  - Kann PH
AD  - Division Endocrinology, Philipps-University Marburg, Marburg, Germany.
FAU - Albers, M B
AU  - Albers MB
AD  - Department of Visceral, Thoracic and Vascular Surgery, Philipps-University 
      Marburg, Marburg, Germany.
FAU - Manoharan, J
AU  - Manoharan J
AD  - Department of Visceral, Thoracic and Vascular Surgery, Philipps-University 
      Marburg, Marburg, Germany.
FAU - Ramaswamy, A
AU  - Ramaswamy A
AD  - Institute of Pathology, Philipps-University Marburg, Marburg, Germany.
FAU - Mahnken, A H
AU  - Mahnken AH
AD  - Department of Radiology, Philipps-University Marburg, Marburg, Germany.
FAU - Bartsch, D K
AU  - Bartsch DK
AD  - Department of Visceral, Thoracic and Vascular Surgery, Philipps-University 
      Marburg, Marburg, Germany.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Surg
JT  - World journal of surgery
JID - 7704052
SB  - IM
CIN - World J Surg. 2018 May;42(5):1448. PMID: 29143084
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - Endosonography
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/*diagnostic imaging/pathology/surgery
MH  - Neuroendocrine Tumors/*diagnostic imaging/pathology/surgery
MH  - Pancreatectomy
MH  - Pancreatic Neoplasms/*diagnostic imaging/pathology/surgery
MH  - *Preoperative Care
MH  - Retrospective Studies
MH  - Tomography, X-Ray Computed
MH  - Young Adult
EDAT- 2017/10/28 06:00
MHDA- 2018/09/06 06:00
CRDT- 2017/10/28 06:00
PHST- 2017/10/28 06:00 [pubmed]
PHST- 2018/09/06 06:00 [medline]
PHST- 2017/10/28 06:00 [entrez]
AID - 10.1007/s00268-017-4317-8 [pii]
AID - 10.1007/s00268-017-4317-8 [doi]
PST - ppublish
SO  - World J Surg. 2018 May;42(5):1440-1447. doi: 10.1007/s00268-017-4317-8.