Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 6/2018

01-06-2018 | Gastrointestinal

Hepatic neuroendocrine tumour: Apparent diffusion coefficient as a potential marker of prognosis associated with tumour grade and overall survival

Authors: Ji Hye Min, Tae Wook Kang, Young Kon Kim, Seong Hyun Kim, Kyung Sook Shin, Jeong Eun Lee, Sang Yun Ha, Insuk Sohn

Published in: European Radiology | Issue 6/2018

Login to get access

Abstract

Objectives

To evaluate the correlation between grade of hepatic neuroendocrine tumours (NETs) according to the 2010 World Health Organization (WHO) classification and the apparent diffusion coefficient (ADC) and to assess whether ADC value can predict overall survival (OS) after diagnosis of hepatic NETs.

Methods

The study included 63 patients who underwent magnetic resonance (MR) imaging with diffusion-weighted images for the evaluation of hepatic NETs. The correlation between qualitative and quantitative MR imaging findings, including ADC values, and WHO classifications was assessed. The association between ADC value and OS was analyzed.

Results

The ADC values and WHO classification of hepatic NETs were moderately negatively correlated in a statistically significant manner (ρ = −0.57, p < 0.001). The OS rates were significantly different according to the ADC value (low ADC vs. high ADC, p = 0.006) as well as WHO classifications (G1+ G2 vs. G3, p = 0.038). However, multivariate analysis revealed that the only independent predictor for OS was a low ADC value (hazard ratio: 3.37, p = 0.010).

Conclusion

There was a significant correlation between the ADC value of hepatic NETs and the WHO tumour grade. Additionally, the ADC value of a hepatic NET might be more accurate than the current WHO tumour grade for predicting OS.

Key points

• ADC values of hepatic NET and WHO tumour grade were negatively correlated.
• Lower ADC values of hepatic NET were significantly correlated with worse OS.
• ADC value might be more accurate than WHO grade for predicting OS.
Literature
1.
Klimstra DS, Modlin IR, Coppola D, Lloyd RV, Suster S (2010) The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems. Pancreas 39:707–712CrossRefPubMed
2.
Saxena A, Chua TC, Perera M, Chu F, Morris DL (2012) Surgical resection of hepatic metastases from neuroendocrine neoplasms: a systematic review. Surg Oncol 21:e131–e141CrossRefPubMed
3.
Cho CS, Labow DM, Tang L et al (2008) Histologic grade is correlated with outcome after resection of hepatic neuroendocrine neoplasms. Cancer 113:126–134CrossRefPubMed
4.
Saxena A, Chua TC, Sarkar A et al (2011) Progression and survival results after radical hepatic metastasectomy of indolent advanced neuroendocrine neoplasms (NENs) supports an aggressive surgical approach. Surgery 149:209–220CrossRefPubMed
5.
Anlauf M (2011) Neuroendocrine neoplasms of the gastroenteropancreatic system: pathology and classification. Horm Metab Res 43:825–831CrossRefPubMed
6.
Pasaoglu E, Dursun N, Ozyalvacli G, Hacihasanoglu E, Behzatoglu K, Calay O (2015) Comparison of World Health Organization 2000/2004 and World Health Organization 2010 classifications for gastrointestinal and pancreatic neuroendocrine tumors. Ann Diagn Pathol 19:81–87CrossRefPubMed
7.
Kloppel G (2011) Classification and pathology of gastroenteropancreatic neuroendocrine neoplasms. Endocr Relat Cancer 18(Suppl 1):S1–16CrossRefPubMed
8.
Padhani AR, Liu G, Koh DM et al (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 11:102–125CrossRefPubMedPubMedCentral
9.
Kim M, Kang TW, Kim YK et al (2016) Pancreatic neuroendocrine tumour: Correlation of apparent diffusion coefficient or WHO classification with recurrence-free survival. Eur J Radiol 85:680–687CrossRefPubMed
10.
Jang KM, Kim SH, Lee SJ, Choi D (2014) The value of gadoxetic acid-enhanced and diffusion-weighted MRI for prediction of grading of pancreatic neuroendocrine tumors. Acta Radiol 55:140–148CrossRefPubMed
11.
Kim JH, Eun HW, Kim YJ, Han JK, Choi BI (2013) Staging accuracy of MR for pancreatic neuroendocrine tumor and imaging findings according to the tumor grade. Abdom Imaging 38:1106–1114CrossRefPubMed
12.
Kang TW, Kim SH, Jang KM et al (2015) Gastrointestinal stromal tumours: correlation of modified NIH risk stratification with diffusion-weighted MR imaging as an imaging biomarker. Eur J Radiol 84:33–40CrossRefPubMed
13.
Attenberger UI, Pilz LR, Morelli JN et al (2014) Multi-parametric MRI of rectal cancer - do quantitative functional MR measurements correlate with radiologic and pathologic tumor stages? Eur J Radiol 83:1036–1043CrossRefPubMed
14.
Akashi M, Nakahusa Y, Yakabe T et al (2014) Assessment of aggressiveness of rectal cancer using 3-T MRI: correlation between the apparent diffusion coefficient as a potential imaging biomarker and histologic prognostic factors. Acta Radiol 55:524–531CrossRefPubMed
15.
ZH L, CH H, Qian WX, Cao WH (2016) Preoperative diffusion-weighted imaging value of rectal cancer: preoperative T staging and correlations with histological T stage. Clin Imaging 40:563–568CrossRef
16.
Shankar S, Kalra N, Bhatia A et al (2016) Role of Diffusion Weighted Imaging (DWI) for Hepatocellular Carcinoma (HCC) Detection and its Grading on 3T MRI: A Prospective Study. J Clin Exp Hepatol 6:303–310CrossRefPubMedPubMedCentral
17.
18.
Besa C, Ward S, Cui Y, Jajamovich G, Kim M, Taouli B (2016) Neuroendocrine liver metastases: Value of apparent diffusion coefficient and enhancement ratios for characterization of histopathologic grade. J Magn Reson Imaging 44:1432–1441CrossRefPubMed
19.
Fenwick SW, Wyatt JI, Toogood GJ, Lodge JP (2004) Hepatic resection and transplantation for primary carcinoid tumors of the liver. Ann Surg 239:210–219CrossRefPubMedPubMedCentral
20.
Knox CD, Anderson CD, Lamps LW, Adkins RB, Pinson CW (2003) Long-term survival after resection for primary hepatic carcinoid tumor. Ann Surg Oncol 10:1171–1175CrossRefPubMed
21.
Kang TW, Rhim H, Lee J et al (2016) Magnetic resonance imaging with gadoxetic acid for local tumour progression after radiofrequency ablation in patients with hepatocellular carcinoma. Eur Radiol 26:3437–3446CrossRefPubMed
22.
Asbach P, Hein PA, Stemmer A et al (2008) Free-breathing echo-planar imaging based diffusion-weighted magnetic resonance imaging of the liver with prospective acquisition correction. J Comput Assist Tomogr 32:372–378CrossRefPubMed
23.
Haradome H, Grazioli L, Tsunoo M et al (2010) Can MR fluoroscopic triggering technique and slow rate injection provide appropriate arterial phase images with reducing artifacts on gadoxetic acid-DTPA (Gd-EOB-DTPA)-enhanced hepatic MR imaging? J Magn Reson Imaging 32:334–340CrossRefPubMed
24.
Tse JR, Naini BV, DS L, Raman SS (2016) Qualitative and Quantitative Gadoxetic Acid-enhanced MR Imaging Helps Subtype Hepatocellular Adenomas. Radiology 279:118–127CrossRefPubMed
25.
Ba-Ssalamah A, Antunes C, Feier D et al (2015) Morphologic and Molecular Features of Hepatocellular Adenoma with Gadoxetic Acid-enhanced MR Imaging. Radiology 277:104–113CrossRefPubMed
26.
Merkle EM, Zech CJ, Bartolozzi C et al (2016) Consensus report from the 7th International Forum for Liver Magnetic Resonance Imaging. Eur Radiol 26:674–682CrossRefPubMed
27.
Hood L, Friend SH (2011) Predictive, personalized, preventive, participatory (P4) cancer medicine. Nat Rev Clin Oncol 8:184–187CrossRefPubMed
28.
Rudin M (2007) Imaging readouts as biomarkers or surrogate parameters for the assessment of therapeutic interventions. Eur Radiol 17:2441–2457CrossRefPubMed
29.
Fairweather M, Swanson R, Wang J et al (2017) Management of Neuroendocrine Tumor Liver Metastases: Long-Term Outcomes and Prognostic Factors from a Large Prospective Database. Ann Surg Oncol 24:2319–2325CrossRefPubMed
30.
Ramage JK, Ahmed A, Ardill J et al (2012) Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut 61:6–32CrossRefPubMed
31.
Wang H, Cruz-Roa A, Basavanhally A et al (2014) Mitosis detection in breast cancer pathology images by combining handcrafted and convolutional neural network features. J Med Imaging (Bellingham) 1:034003CrossRef
32.
Adesoye T, Daleo MA, Loeffler AG, Winslow ER, Weber SM, Cho CS (2015) Discordance of Histologic Grade Between Primary and Metastatic Neuroendocrine Carcinomas. Ann Surg Oncol 22(Suppl 3):S817–S821CrossRefPubMedPubMedCentral
33.
Janson ET, Holmberg L, Stridsberg M et al (1997) Carcinoid tumors: analysis of prognostic factors and survival in 301 patients from a referral center. Ann Oncol 8:685–690CrossRefPubMed
34.
Shen YH, Chen S, Zhang WT et al (2014) Clinical analysis of gastroenteropancreatic neuroendocrine tumor with liver metastasis, compared with primary hepatic neuroendocrine tumor. J Cancer Res Ther 10(Suppl):276–280PubMed
35.
Yang Z, Tang LH, Klimstra DS (2011) Effect of tumor heterogeneity on the assessment of Ki67 labeling index in well-differentiated neuroendocrine tumors metastatic to the liver: implications for prognostic stratification. Am J Surg Pathol 35:853–860CrossRefPubMed
Metadata
Title
Hepatic neuroendocrine tumour: Apparent diffusion coefficient as a potential marker of prognosis associated with tumour grade and overall survival
Authors
Ji Hye Min
Tae Wook Kang
Young Kon Kim
Seong Hyun Kim
Kyung Sook Shin
Jeong Eun Lee
Sang Yun Ha
Insuk Sohn
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/s00330-017-5248-3

Other articles of this Issue 6/2018

European Radiology 6/2018 Go to the issue

Oncology

Fat necrosis after abdominal surgery: A pitfall in interpretation of FDG-PET/CT

Gastrointestinal

Demystifying liver iron concentration measurements with MRI

Magnetic Resonance

Proton density fat fraction (PDFF) MRI for differentiation of benign and malignant vertebral lesions

Magnetic Resonance

Magnetic resonance cholangiopancreatography with GRASE sequence at 3.0T: does it improve image quality and acquisition time as compared with 3D TSE?

Gastrointestinal

The diagnostic performance of reduced-dose CT for suspected appendicitis in paediatric and adult patients: A systematic review and diagnostic meta-analysis

Breast

Preclinical ex vivo evaluation of the diagnostic performance of a new device for in situ label-free fluorescence spectral analysis of breast masses