PMID- 32709455 OWN - NLM STAT- MEDLINE DCOM- 20210714 LR - 20210714 IS - 2211-5684 (Electronic) IS - 2211-5684 (Linking) VI - 101 IP - 12 DP - 2020 Dec TI - Morphological imaging and CT histogram analysis to differentiate pancreatic neuroendocrine tumor grade 3 from neuroendocrine carcinoma. PG - 821-830 LID - S2211-5684(20)30183-2 [pii] LID - 10.1016/j.diii.2020.06.006 [doi] AB - PURPOSE: To compare morphological imaging features and CT texture histogram parameters between grade 3 pancreatic neuroendocrine tumors (G3-NET) and neuroendocrine carcinomas (NEC). MATERIALS AND METHODS: Patients with pathologically proven G3-NET and NEC, according to the 2017 World Health Organization classification who had CT and MRI examinations between 2006-2017 were retrospectively included. CT and MRI examinations were reviewed by two radiologists in consensus and analyzed with respect to tumor size, enhancement patterns, hemorrhagic content, liver metastases and lymphadenopathies. Texture histogram analysis of tumors was performed on arterial and portal phase CT images. images. Morphological imaging features and CT texture histogram parameters of G3-NETs and NECs were compared. RESULTS: Thirty-seven patients (21 men, 16 women; mean age, 56+/-13 [SD] years [range: 28-82 years]) with 37 tumors (mean diameter, 60+/-46 [SD] mm) were included (CT available for all, MRI for 16/37, 43%). Twenty-three patients (23/37; 62%) had NEC and 14 patients (14/37; 38%) had G3-NET. NECs were larger than G3-NETs (mean, 70+/-51 [SD] mm [range: 18 - 196mm] vs. 42+/-24 [SD] mm [range: 8 - 94mm], respectively; P=0.039), with more tumor necrosis (75% vs. 33%, respectively; P=0.030) and lower attenuation on precontrast (30+/-4 [SD] HU [range: 25-39 HU] vs. 37+/-6 [SD] [range: 25-45 HU], respectively; P=0.002) and on portal venous phase CT images (75+/-18 [SD] HU [range: 43 - 108 HU] vs. 92+/-19 [SD] HU [range: 46 - 117 HU], respectively; P=0.014). Hemorrhagic content on MRI was only observed in NEC (P=0.007). The mean ADC value was lower in NEC ([1.1+/-0.1 (SD)]x10(-3) mm(2)/s [range: (0.91 - 1.3)x10(-3) mm(2)/s] vs. [1.4+/-0.2 (SD)]x10(-3) mm(2)/s [range: (1.1 - 1.6)x10(-3) mm(2)/s]; P=0.005). CT histogram analysis showed that NEC were more heterogeneous on portal venous phase images (Entropy-0: 4.7+/-0.2 [SD] [range: 4.2-5.1] vs. 4.5+/-0.4 [SD] [range: 3.7-4.9]; P=0.023). CONCLUSION: Pancreatic NECs are larger, more frequently hypoattenuating and more heterogeneous with hemorrhagic content than G3-NET on CT and MRI. CI - Copyright (c) 2020 Societe francaise de radiologie. Published by Elsevier Masson SAS. All rights reserved. FAU - Azoulay, A AU - Azoulay A AD - Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Assistance Publique-Hopitaux de Paris, 92118 Clichy, France. FAU - Cros, J AU - Cros J AD - Department of Pathology, University Hospitals Paris Nord Val de Seine, Beaujon Assistance Publique-Hopitaux de Paris, 92118 Clichy, France; Universite de Paris, Diderot Paris 7, 75010 Paris, France; INSERM U1149, CRI, Paris, France. FAU - Vullierme, M-P AU - Vullierme MP AD - Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Assistance Publique-Hopitaux de Paris, 92118 Clichy, France. FAU - de Mestier, L AU - de Mestier L AD - Universite de Paris, Diderot Paris 7, 75010 Paris, France; Department of Pancreatology, University Hospitals Paris Nord Val de Seine, Beaujon Assistance Publique-Hopitaux de Paris, 92118 Clichy, France; INSERM U1149, CRI, Paris, France. FAU - Couvelard, A AU - Couvelard A AD - Department of Pathology, University Hospitals Paris Nord Val de Seine, Beaujon Assistance Publique-Hopitaux de Paris, 92118 Clichy, France; Universite de Paris, Diderot Paris 7, 75010 Paris, France; INSERM U1149, CRI, Paris, France. FAU - Hentic, O AU - Hentic O AD - Department of Pancreatology, University Hospitals Paris Nord Val de Seine, Beaujon Assistance Publique-Hopitaux de Paris, 92118 Clichy, France. FAU - Ruszniewski, P AU - Ruszniewski P AD - Universite de Paris, Diderot Paris 7, 75010 Paris, France; Department of Pancreatology, University Hospitals Paris Nord Val de Seine, Beaujon Assistance Publique-Hopitaux de Paris, 92118 Clichy, France; INSERM U1149, CRI, Paris, France. FAU - Sauvanet, A AU - Sauvanet A AD - Department of HPB Surgery, University Hospitals Paris Nord Val de Seine, Beaujon Assistance Publique-Hopitaux de Paris, 92118 Clichy, France. FAU - Vilgrain, V AU - Vilgrain V AD - Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Assistance Publique-Hopitaux de Paris, 92118 Clichy, France; Universite de Paris, Diderot Paris 7, 75010 Paris, France; INSERM U1149, CRI, Paris, France. FAU - Ronot, M AU - Ronot M AD - Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Assistance Publique-Hopitaux de Paris, 92118 Clichy, France; Universite de Paris, Diderot Paris 7, 75010 Paris, France; INSERM U1149, CRI, Paris, France. Electronic address: maxime.ronot@aphp.fr. LA - eng PT - Journal Article DEP - 20200721 PL - France TA - Diagn Interv Imaging JT - Diagnostic and interventional imaging JID - 101568499 SB - IM MH - *Carcinoma, Neuroendocrine/diagnostic imaging/pathology MH - Female MH - Humans MH - Image Processing, Computer-Assisted MH - Male MH - Middle Aged MH - Neoplasm Grading MH - *Pancreatic Neoplasms/diagnostic imaging/pathology MH - Retrospective Studies MH - Tomography, X-Ray Computed OTO - NOTNLM OT - Magnetic resonance imaging OT - Neuroendocrine tumors OT - OMS 2017 OT - Texture analysis OT - Tomography, X-ray computed EDAT- 2020/07/28 06:00 MHDA- 2021/07/15 06:00 CRDT- 2020/07/26 06:00 PHST- 2020/05/05 00:00 [received] PHST- 2020/06/28 00:00 [revised] PHST- 2020/06/29 00:00 [accepted] PHST- 2020/07/28 06:00 [pubmed] PHST- 2021/07/15 06:00 [medline] PHST- 2020/07/26 06:00 [entrez] AID - S2211-5684(20)30183-2 [pii] AID - 10.1016/j.diii.2020.06.006 [doi] PST - ppublish SO - Diagn Interv Imaging. 2020 Dec;101(12):821-830. doi: 10.1016/j.diii.2020.06.006. Epub 2020 Jul 21.