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European Radiology
Published in: European Radiology 6/2018

01-06-2018 | Hepatobiliary-Pancreas

Can histogram analysis of MR images predict aggressiveness in pancreatic neuroendocrine tumors?

Authors: Riccardo De Robertis, Bogdan Maris, Nicolò Cardobi, Paolo Tinazzi Martini, Stefano Gobbo, Paola Capelli, Silvia Ortolani, Sara Cingarlini, Salvatore Paiella, Luca Landoni, Giovanni Butturini, Paolo Regi, Aldo Scarpa, Giampaolo Tortora, Mirko D’Onofrio

Published in: European Radiology | Issue 6/2018

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Abstract

Objectives

To evaluate MRI derived whole-tumour histogram analysis parameters in predicting pancreatic neuroendocrine neoplasm (panNEN) grade and aggressiveness.

Methods

Pre-operative MR of 42 consecutive patients with panNEN >1 cm were retrospectively analysed. T1-/T2-weighted images and ADC maps were analysed. Histogram-derived parameters were compared to histopathological features using the Mann-Whitney U test. Diagnostic accuracy was assessed by ROC-AUC analysis; sensitivity and specificity were assessed for each histogram parameter.

Results

ADCentropy was significantly higher in G2-3 tumours with ROC-AUC 0.757; sensitivity and specificity were 83.3 % (95 % CI: 61.2–94.5) and 61.1 % (95 % CI: 36.1–81.7). ADCkurtosis was higher in panNENs with vascular involvement, nodal and hepatic metastases (p= .008, .021 and .008; ROC-AUC= 0.820, 0.709 and 0.820); sensitivity and specificity were: 85.7/74.3 % (95 % CI: 42–99.2 /56.4–86.9), 36.8/96.5 % (95 % CI: 17.2–61.4 /76–99.8) and 100/62.8 % (95 % CI: 56.1–100/44.9–78.1). No significant differences between groups were found for other histogram-derived parameters (p >.05).

Conclusions

Whole-tumour histogram analysis of ADC maps may be helpful in predicting tumour grade, vascular involvement, nodal and liver metastases in panNENs. ADCentropy and ADCkurtosis are the most accurate parameters for identification of panNENs with malignant behaviour.

Key Points

• Whole-tumour ADC histogram analysis can predict aggressiveness in pancreatic neuroendocrine neoplasms.
• ADC entropy and kurtosis are higher in aggressive tumours.
• ADC histogram analysis can quantify tumour diffusion heterogeneity.
• Non-invasive quantification of tumour heterogeneity can provide adjunctive information for prognostication.
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Metadata
Title
Can histogram analysis of MR images predict aggressiveness in pancreatic neuroendocrine tumors?
Authors
Riccardo De Robertis
Bogdan Maris
Nicolò Cardobi
Paolo Tinazzi Martini
Stefano Gobbo
Paola Capelli
Silvia Ortolani
Sara Cingarlini
Salvatore Paiella
Luca Landoni
Giovanni Butturini
Paolo Regi
Aldo Scarpa
Giampaolo Tortora
Mirko D’Onofrio
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5236-7

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