Purpose
Method of differential diagnosis of neuroendocrine neoplasms (NEN) of pancreas grades and pancreatic cancer using MDCT was introduced:
Main MDCT signs of malignancy of neuroendocrine neoplasms of pancreas are heterogeneous angioarchitectonic,
disoder of perfusion and vascular permeability.
While tumor grows,
necrosis is observed in the central area that says about blood supply disturbance.
20%-25% of the tumors contain calcification.
Invasion into surround organs and vessels,
metastasis (fig.
1) indicate high grade of NEN [1-3,5].
Non-functional NEN may be treated incorrectly as pancreatic cancer because of...
Methods and Materials
MDCT with intravenous contrast has been done for 52 patients with NEN of pancreas and 50 patients with pancreatic cancer.
Patients’ age 50,6+14,5 and 57,2+11,4 years.
Images of patients with NEN were analyzed according to the WHO classification of 2010.
Density of tumor and parenchyma of pancreas has been assessed for all phases of MDCT.
Tumor accumulation gradient relative to pancreatic tissue was calculated as difference of the density of tumor and pancreas for all phases of the study.
The calculation formula for the tumor...
Results
NEN of pancreas are heterogeneous group of tumors in terms of their dynamics of contrast medium accumulation.
No reliable difference of the accumulation gradient for NEN of pancreas with G1 and G2 grades (fig.
2,
3).
Accumulation gradient for G1: -0.2; 13.4; 8.0; 12.6 and standard deviation: 13.2; 36.2; 21.8; 10.4 (by four study phases).
Accumulation gradient for G2: 4.3; 43.8; 28.7; 20.0 and standard deviation: 16.5; 56.6; 21.7; 15.0 (by four study phases) (fig.
4).
G3 grade (fig.
5) and pancreatic cancer (fig.
6)...
Conclusion
G1 and G2 could not be differentiated from each other using MDCT.
G3 could be differentiated from G1 and G2,
but differentiation from pancreatic cancer is difficult.
Tumor size does not differentiate the grade degree (fig.
9-11).
References
Caplin M.
Current Status Of the Diagnosis and Treatment of Hereditary and Sporadic Neuroendocrine Tumors of the Gastroenteropancreatic System.
Diagnostic algorithms for GEP NET An Educational Conference of the European Neuroendocrine Tumor Network – Budapesht,
2004
Tomoaki Ichikawa,
MD Mark S.
Peterson,
MD Michael P.
Federle,
MD Richard L.
Baron,
MD Hiroki Haradome,
MD Yasuhiro Kawamori,
MD Shigeru Nawano,
MD Tsutomu ArakiIslet сell tumor of the pancreas: biphasic CT versus MR Imaging in tumor detectionRadiology 2000; 216:163–171
House MG,
Schulick RD 2006 Endocrine tumors of...