Skip to main content
Top
Published in: Abdominal Radiology 2/2019

01-02-2019

Textural analysis on contrast-enhanced CT in pancreatic neuroendocrine neoplasms: association with WHO grade

Authors: Chuangen Guo, Xiaoling Zhuge, Zhongqiu Wang, Qidong Wang, Ke Sun, Zhan Feng, Xiao Chen

Published in: Abdominal Radiology | Issue 2/2019

Login to get access

Abstract

Purpose

Grades of pancreatic neuroendocrine neoplasms (PNENs) are associated with the choice of treatment strategies. Texture analysis has been used in tumor diagnosis and staging evaluation. In this study, we aim to evaluate the potential ability of texture parameters in differentiation of PNENs grades.

Materials and methods

37 patients with histologically proven PNENs and underwent pretreatment dynamic contrast-enhanced computed tomography examinations were retrospectively analyzed. Imaging features and texture features at contrast-enhanced images were evaluated. Receiver operating characteristic curves were used to determine the cut-off values and the sensitivity and specificity of prediction.

Results

There were significant differences in tumor margin, pancreatic duct dilatation, lymph nodes invasion, size, portal enhancement ratio (PER), arterial enhancement ratio (AER), mean grey-level intensity, kurtosis, entropy, and uniformity among G1, G2, and pancreatic neuroendocrine carcinoma (PNEC) G3 (p < 0.01). Similar results were found between pancreatic neuroendocrine tumors (PNETs) G1/G2 and PNEC G3. AER and PER showed the best sensitivity (0.86–0.94) and specificity (0.92–1.0) for differentiating PNEC G3 from PNETs G1/G2. Mean grey-level intensity, entropy, and uniformity also showed acceptable sensitivity (0.73–0.91) and specificity (0.85–1.0). Mean grey-level intensity was also showed acceptable sensitivity (91% to 100%) and specificity (82% to 91%) in differentiating PNET G1 from PNET G2.

Conclusions

Our data indicated that texture parameters have potential in grading PNENs, in particular in differentiating PNEC G3 from PNETs G1/G2.
Literature
1.
go back to reference Wang Y, Miller FH, Chen ZE, et al. (2011) Diffusion-weighted MR imaging of solid and cystic lesions of the pancreas. Radiographics 31(3):E47–E64CrossRefPubMed Wang Y, Miller FH, Chen ZE, et al. (2011) Diffusion-weighted MR imaging of solid and cystic lesions of the pancreas. Radiographics 31(3):E47–E64CrossRefPubMed
2.
go back to reference Dasari A, Shen C, Halperin D, et al. (2017) Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol 3:1335–1342CrossRefPubMedPubMedCentral Dasari A, Shen C, Halperin D, et al. (2017) Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol 3:1335–1342CrossRefPubMedPubMedCentral
3.
go back to reference Klimstra DS, Arnold R, Capella C (2010) Neuroendocrine neoplasms of the pancreas. In: Bosman FT, Carneiro F, Hruban RH, Theise ND (eds) WHO Classification of Tumours of the Digestive System. Lyon: International Agency for Research on Cancer (IARC), pp 322–326 Klimstra DS, Arnold R, Capella C (2010) Neuroendocrine neoplasms of the pancreas. In: Bosman FT, Carneiro F, Hruban RH, Theise ND (eds) WHO Classification of Tumours of the Digestive System. Lyon: International Agency for Research on Cancer (IARC), pp 322–326
4.
go back to reference Kulke MH, Shah MH, Benson Al B, et al. (2014) NCCN guidelines Neuroendocrine tumors version 2. Accessed March. Kulke MH, Shah MH, Benson Al B, et al. (2014) NCCN guidelines Neuroendocrine tumors version 2. Accessed March.
5.
go back to reference Burns WR, Edil BH (2012) Neuroendocrine pancreatic tumors: guidelines for management and update. Curr Treat Options Oncol 13(1):24–34CrossRefPubMed Burns WR, Edil BH (2012) Neuroendocrine pancreatic tumors: guidelines for management and update. Curr Treat Options Oncol 13(1):24–34CrossRefPubMed
6.
go back to reference Yao JC, Shah MH, Ito T, et al. (2011) RAD001 in Advanced Neuroendocrine Tumors, Third Trial (RADIANT-3) Study Group. Everolimus for advanced pancreatic neuroendocrine tumors. N Engl J Med 364(6):514–523CrossRefPubMedPubMedCentral Yao JC, Shah MH, Ito T, et al. (2011) RAD001 in Advanced Neuroendocrine Tumors, Third Trial (RADIANT-3) Study Group. Everolimus for advanced pancreatic neuroendocrine tumors. N Engl J Med 364(6):514–523CrossRefPubMedPubMedCentral
7.
go back to reference Raymond E, Dahan L, Raoul JL, et al. (2011) Sunitinib malate for the treatment of pancreatic neuroendocrine tumors. N Engl J Med 364(6):501–513CrossRefPubMed Raymond E, Dahan L, Raoul JL, et al. (2011) Sunitinib malate for the treatment of pancreatic neuroendocrine tumors. N Engl J Med 364(6):501–513CrossRefPubMed
8.
go back to reference Cappelli C, Boggi U, Mazzeo S, et al. (2015) Contrast enhancement pattern on multidetector CT predicts malignancy in pancreatic endocrine tumours. Eur Radiol 25(3):751–759CrossRefPubMed Cappelli C, Boggi U, Mazzeo S, et al. (2015) Contrast enhancement pattern on multidetector CT predicts malignancy in pancreatic endocrine tumours. Eur Radiol 25(3):751–759CrossRefPubMed
9.
go back to reference Kim DW, Kim HJ, Kim KW, et al. (2015) Neuroendocrine neoplasms of the pancreas at dynamic enhanced CT: comparison between grade 3 neuroendocrine carcinoma and grade 1/2 neuroendocrine tumour. Eur Radiol 25(5):1375–1383CrossRefPubMed Kim DW, Kim HJ, Kim KW, et al. (2015) Neuroendocrine neoplasms of the pancreas at dynamic enhanced CT: comparison between grade 3 neuroendocrine carcinoma and grade 1/2 neuroendocrine tumour. Eur Radiol 25(5):1375–1383CrossRefPubMed
10.
go back to reference Takumi K, Fukukura Y, Higashi M, et al. (2015) Pancreatic neuroendocrine tumors: Correlation between the contrast-enhanced computed tomography features and the pathological tumor grade. Eur J Radiol 84(8):1436–1443CrossRefPubMed Takumi K, Fukukura Y, Higashi M, et al. (2015) Pancreatic neuroendocrine tumors: Correlation between the contrast-enhanced computed tomography features and the pathological tumor grade. Eur J Radiol 84(8):1436–1443CrossRefPubMed
11.
go back to reference Horiguchi S, Kato H, Shiraha H, et al. (2017) Dynamic computed tomography is useful for prediction of pathological grade in pancreatic neuroendocrine neoplasm. J Gastroenterol Hepatol 32(4):925–931CrossRefPubMed Horiguchi S, Kato H, Shiraha H, et al. (2017) Dynamic computed tomography is useful for prediction of pathological grade in pancreatic neuroendocrine neoplasm. J Gastroenterol Hepatol 32(4):925–931CrossRefPubMed
12.
go back to reference Lotfalizadeh E, Ronot M, Wagner M, et al. (2017) Prediction of pancreatic neuroendocrine tumour grade with MR imaging features: added value of diffusion-weighted imaging. Eur Radiol 27(4):1748–1759CrossRefPubMed Lotfalizadeh E, Ronot M, Wagner M, et al. (2017) Prediction of pancreatic neuroendocrine tumour grade with MR imaging features: added value of diffusion-weighted imaging. Eur Radiol 27(4):1748–1759CrossRefPubMed
13.
go back to reference Guo C, Chen X, Xiao W, et al. (2017) Pancreatic neuroendocrine neoplasms at magnetic resonance imaging: comparison between grade 3 and grade 1/2 tumors. Onco Targets Ther 10:1465–1474CrossRefPubMedPubMedCentral Guo C, Chen X, Xiao W, et al. (2017) Pancreatic neuroendocrine neoplasms at magnetic resonance imaging: comparison between grade 3 and grade 1/2 tumors. Onco Targets Ther 10:1465–1474CrossRefPubMedPubMedCentral
14.
go back to reference Giganti F, Antunes S, Salerno A, et al. (2017) Gastric cancer: texture analysis from multidetector computed tomography as a potential preoperative prognostic biomarker. Eur Radiol 27(5):1831–1839CrossRefPubMed Giganti F, Antunes S, Salerno A, et al. (2017) Gastric cancer: texture analysis from multidetector computed tomography as a potential preoperative prognostic biomarker. Eur Radiol 27(5):1831–1839CrossRefPubMed
15.
go back to reference Aerts HJ, Velazquez ER, Leijenaar RT, et al. (2014) Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun 5:4006CrossRefPubMedPubMedCentral Aerts HJ, Velazquez ER, Leijenaar RT, et al. (2014) Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun 5:4006CrossRefPubMedPubMedCentral
16.
go back to reference Choi ER, Lee HY, Jeong JY, et al. (2016) Quantitative image variables reflect the intratumoral pathologic heterogeneity of lung adenocarcinoma. Oncotarget 7(41):67302–67313CrossRefPubMedPubMedCentral Choi ER, Lee HY, Jeong JY, et al. (2016) Quantitative image variables reflect the intratumoral pathologic heterogeneity of lung adenocarcinoma. Oncotarget 7(41):67302–67313CrossRefPubMedPubMedCentral
17.
go back to reference Summers RM (2017) Texture analysis in radiology: Does the emperor have no clothes? Abdom Radiol (NY) 42(2):342–345CrossRef Summers RM (2017) Texture analysis in radiology: Does the emperor have no clothes? Abdom Radiol (NY) 42(2):342–345CrossRef
18.
go back to reference Sacconi B, Anzidei M, Leonardi A, et al. (2017) Analysis of CT features and quantitative texture analysis in patients with lung adenocarcinoma: a correlation with EGFR mutations and survival rates. Clin Radiol 72(6):443–450CrossRefPubMed Sacconi B, Anzidei M, Leonardi A, et al. (2017) Analysis of CT features and quantitative texture analysis in patients with lung adenocarcinoma: a correlation with EGFR mutations and survival rates. Clin Radiol 72(6):443–450CrossRefPubMed
19.
go back to reference Ramkumar S, Ranjbar S, Ning S, et al. (2017) MRI-based texture analysis to differentiate sinonasal squamous cell carcinoma from inverted papilloma. AJNR Am J Neuroradiol 38(5):1019–1025CrossRefPubMed Ramkumar S, Ranjbar S, Ning S, et al. (2017) MRI-based texture analysis to differentiate sinonasal squamous cell carcinoma from inverted papilloma. AJNR Am J Neuroradiol 38(5):1019–1025CrossRefPubMed
20.
go back to reference Nketiah G, Elschot M, Kim E, et al. (2017) T2-weighted MRI-derived textural features reflect prostate cancer aggressiveness: preliminary results. Eur Radiol 27(7):3050–3059CrossRefPubMed Nketiah G, Elschot M, Kim E, et al. (2017) T2-weighted MRI-derived textural features reflect prostate cancer aggressiveness: preliminary results. Eur Radiol 27(7):3050–3059CrossRefPubMed
21.
go back to reference Kim JH, Ko ES, Lim Y, et al. (2017) Breast cancer heterogeneity: MR imaging texture analysis and survival outcomes. Radiology 282(3):665–675CrossRefPubMed Kim JH, Ko ES, Lim Y, et al. (2017) Breast cancer heterogeneity: MR imaging texture analysis and survival outcomes. Radiology 282(3):665–675CrossRefPubMed
22.
go back to reference Zhang S, Zhang B, Tian J, et al. (2017) Radiomics features of multiparametric MRI as novel prognostic factors in advanced nasopharyngeal carcinoma. Clin Cancer Res 23(15):4259–4269CrossRefPubMed Zhang S, Zhang B, Tian J, et al. (2017) Radiomics features of multiparametric MRI as novel prognostic factors in advanced nasopharyngeal carcinoma. Clin Cancer Res 23(15):4259–4269CrossRefPubMed
23.
go back to reference Pereira JA, Rosado E, Bali M, et al. (2015) Pancreatic neuroendocrine tumors: correlation between histogram analysis of apparent diffusion coefficient maps and tumor grade. Abdom Imaging 40(8):3122–3128CrossRefPubMed Pereira JA, Rosado E, Bali M, et al. (2015) Pancreatic neuroendocrine tumors: correlation between histogram analysis of apparent diffusion coefficient maps and tumor grade. Abdom Imaging 40(8):3122–3128CrossRefPubMed
24.
go back to reference Canellas R, Burk KS, Parakh A, et al. (2018) Prediction of pancreatic neuroendocrine tumor grade based on CT features and texture analysis. AJR Am J Roentgenol 210(2):341–346CrossRefPubMed Canellas R, Burk KS, Parakh A, et al. (2018) Prediction of pancreatic neuroendocrine tumor grade based on CT features and texture analysis. AJR Am J Roentgenol 210(2):341–346CrossRefPubMed
25.
go back to reference Choi TW, Kim JH, Yu MH, et al. (2018) Pancreatic neuroendocrine tumor: prediction of the tumor grade using CT findings and computerized texture analysis. Acta Radiol 59(4):383–392CrossRefPubMed Choi TW, Kim JH, Yu MH, et al. (2018) Pancreatic neuroendocrine tumor: prediction of the tumor grade using CT findings and computerized texture analysis. Acta Radiol 59(4):383–392CrossRefPubMed
26.
go back to reference Ganeshan B, Miles KA, Young RC, et al. (2007) Hepatic entropy and uniformity: additional parameters that can potentially increase the effectiveness of contrast enhancementduring abdominal CT. Clin Radiol 62(8):761–768CrossRefPubMed Ganeshan B, Miles KA, Young RC, et al. (2007) Hepatic entropy and uniformity: additional parameters that can potentially increase the effectiveness of contrast enhancementduring abdominal CT. Clin Radiol 62(8):761–768CrossRefPubMed
27.
go back to reference Miles KA, Ganeshan B, Hayball MP (2013) CT texture analysis using the filtration-histogram method: what do the measurements mean? Cancer Imaging 13(3):400–406CrossRefPubMedPubMedCentral Miles KA, Ganeshan B, Hayball MP (2013) CT texture analysis using the filtration-histogram method: what do the measurements mean? Cancer Imaging 13(3):400–406CrossRefPubMedPubMedCentral
28.
go back to reference Goh V, Ganeshan B, Nathan P, et al. (2011) Assessment of response to tyrosine kinase inhibitors in metastatic renal cell cancer: CT texture as a predictive biomarker. Radiology 261(1):165–171CrossRefPubMed Goh V, Ganeshan B, Nathan P, et al. (2011) Assessment of response to tyrosine kinase inhibitors in metastatic renal cell cancer: CT texture as a predictive biomarker. Radiology 261(1):165–171CrossRefPubMed
29.
go back to reference Rao SX, Lambregts DM, Schnerr RS, et al. (2014) Whole-liver CT texture analysis in colorectal cancer: Does the presence of liver metastases affect the texture of the remaining liver? United Eur Gastroenterol J 2(6):530–538CrossRef Rao SX, Lambregts DM, Schnerr RS, et al. (2014) Whole-liver CT texture analysis in colorectal cancer: Does the presence of liver metastases affect the texture of the remaining liver? United Eur Gastroenterol J 2(6):530–538CrossRef
30.
go back to reference Li M, Fu S, Zhu Y, et al. (2016) Computed tomography texture analysis to facilitate therapeutic decision making in hepatocellular carcinoma. Oncotarget 7(11):13248–13259PubMedPubMedCentral Li M, Fu S, Zhu Y, et al. (2016) Computed tomography texture analysis to facilitate therapeutic decision making in hepatocellular carcinoma. Oncotarget 7(11):13248–13259PubMedPubMedCentral
31.
go back to reference Miles KA, Ganeshan B, Griffiths MR, et al. (2009) Colorectal cancer: texture analysis of portal phase hepatic CT images as a potential marker of survival. Radiology 250(2):444–452CrossRefPubMed Miles KA, Ganeshan B, Griffiths MR, et al. (2009) Colorectal cancer: texture analysis of portal phase hepatic CT images as a potential marker of survival. Radiology 250(2):444–452CrossRefPubMed
32.
go back to reference Guggenbuhl P, Chappard D, Garreau M, et al. (2008) Reproducibility of CT-based bone texture parameters of cancellous calf bone samples: influence of slice thickness. Eur J Radiol 67(3):514–520CrossRefPubMed Guggenbuhl P, Chappard D, Garreau M, et al. (2008) Reproducibility of CT-based bone texture parameters of cancellous calf bone samples: influence of slice thickness. Eur J Radiol 67(3):514–520CrossRefPubMed
Metadata
Title
Textural analysis on contrast-enhanced CT in pancreatic neuroendocrine neoplasms: association with WHO grade
Authors
Chuangen Guo
Xiaoling Zhuge
Zhongqiu Wang
Qidong Wang
Ke Sun
Zhan Feng
Xiao Chen
Publication date
01-02-2019
Publisher
Springer US
Published in
Abdominal Radiology / Issue 2/2019
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-018-1763-1

Other articles of this Issue 2/2019

Abdominal Radiology 2/2019 Go to the issue