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European Radiology
Published in: European Radiology 3/2015

01-03-2015 | Oncology

Contrast enhancement pattern on multidetector CT predicts malignancy in pancreatic endocrine tumours

Authors: Carla Cappelli, Ugo Boggi, Salvatore Mazzeo, Rosa Cervelli, Daniela Campani, Niccola Funel, Benedetta Pontillo Contillo, Carlo Bartolozzi

Published in: European Radiology | Issue 3/2015

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Abstract

Objectives

Preoperative suspicion of malignancy in pancreatic neuroendocrine tumours (pNETs) is mostly based on tumour size. We retrospectively reviewed the contrast enhancement pattern (CEP) of a series of pNETs on multiphasic multidetector computed tomography (MDCT), to identify further imaging features predictive of lesion aggressiveness.

Methods

Sixty pNETs, diagnosed in 52 patients, were classified based on CEP as: type A showing early contrast enhancement and rapid wash-out; type B presenting even (B1) or only (B2) late enhancement. All tumours were resected allowing pathologic correlations.

Results

Nineteen pNETs showed type A CEP (5–20 mm), 29 type B1 CEP (5–80 mm) and 12 type B2 (15–100 mm). All tumours were classified as well differentiated tumours, 19 were benign (WDt-b), 15 with uncertain behaviour (WDt-u) and 26 carcinomas (WDC). None of A lesions were malignant (12 WDt-b; 7 WDt-u), all B2 lesions were WDC, 7 B1 lesions were WDt-b, 8 WDt-u and 14 WDC; 4/34 (12 %) lesions ≤2cm were WDC.
CEP showed correlation with all histological prognostic indicators.

Conclusions

Correlating with the lesion grading and other histological prognostic predictors, CEP may preoperatively suggest the behaviour of pNETs, assisting decisions about treatment. Moreover CEP allows recognition of malignant small tumours, incorrectly classified on the basis of their dimension.

Key Points

• Neuroendocrine pancreatic tumours (pNETs) show different post-contrast behaviour on CT.
• P NETs can be classified on the basis of contrast enhancement into three categories.
• CT classification of pNETs shows strong correlation with histological prognostic factors.
• CT pattern may suggest the optimal management of pNETs.
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Metadata
Title
Contrast enhancement pattern on multidetector CT predicts malignancy in pancreatic endocrine tumours
Authors
Carla Cappelli
Ugo Boggi
Salvatore Mazzeo
Rosa Cervelli
Daniela Campani
Niccola Funel
Benedetta Pontillo Contillo
Carlo Bartolozzi
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3485-2

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