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European Radiology
Published in: European Radiology 7/2015

01-07-2015 | Gastrointestinal

CT differentiation of poorly-differentiated gastric neuroendocrine tumours from well-differentiated neuroendocrine tumours and gastric adenocarcinomas

Authors: Seong Ho Kim, Se Hyung Kim, Min-A Kim, Cheong-il Shin, Joon Koo Han, Byung Ihn Choi

Published in: European Radiology | Issue 7/2015

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Abstract

Purpose

To evaluate the differential CT features of gastric poorly-differentiated neuroendocrine tumours (PD-NETs) from well-differentiated NETs (WD-NETs) and gastric adenocarcinomas (ADCs) and to suggest differential features of hepatic metastases from gastric NETs and ADCs.

Materials and methods

Our study population was comprised of 36 patients with gastric NETs (18 WD-NETs, 18 PD-NETs) and 38 patients with gastric ADCs who served as our control group. Multiple CT features were assessed to identify significant differential CT findings of PD-NETs from WD-NETs and ADCs. In addition, CT features of hepatic metastases including the metastasis-to-liver ratio were analyzed to differentiate metastatic NETs from ADCs.

Results

The presence of metastatic lymph nodes was the sole differentiator of PD-NETs from WD-NETs (P = .001, odds ratio = 56.67), while the presence of intact overlying mucosa with mucosal tenting was the sole significant CT feature differentiating PD-NETs from ADCs (P = .047, odds ratio = 15.3) For hepatic metastases, metastases from NETs were more hyper-attenuated than those from ADCs.

Conclusion

The presence of metastatic LNs and intact overlying mucosa with mucosal tenting are useful CT discriminators of PD-NETs from WD-NETs and ADCs, respectively. In addition, a higher metastasis-to-liver ratio may help differentiate hepatic metastases of gastric NETs from those of gastric ADCs with high accuracy.

Key Points

• Presence of metastatic LNs is a useful differentiator of PD-NETs from WD-NETs.
• Intact overlying mucosa with mucosal tenting suggests PD-NETs more than gastric ADCs.
• Metastatic LNs are larger in size and greater in necrotic volume in PD-NETs.
• Hepatic metastases from gastric NETs are more hyper-attenuated than those from ADCs.
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Metadata
Title
CT differentiation of poorly-differentiated gastric neuroendocrine tumours from well-differentiated neuroendocrine tumours and gastric adenocarcinomas
Authors
Seong Ho Kim
Se Hyung Kim
Min-A Kim
Cheong-il Shin
Joon Koo Han
Byung Ihn Choi
Publication date
01-07-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3600-z

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