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Published in: European Radiology 4/2022

01-04-2022 | Magnetic Resonance Imaging | Hepatobiliary-Pancreas

Prediction of recurrence after surgery based on preoperative MRI features in patients with pancreatic neuroendocrine tumors

Authors: Seungchul Han, Jung Hoon Kim, Jeongin Yoo, Siwon Jang

Published in: European Radiology | Issue 4/2022

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Abstract

Objectives

To investigate useful MRI features in pancreatic neuroendocrine tumor (PNET) patients for predicting recurrence and its timing after surgery.

Methods

A total of 99 patients with PNET who underwent MRI and surgery from 2000 to 2018 were enrolled. Two radiologists independently assessed MRI findings, including size, location, margin, T1 and T2 signal intensity, enhancement patterns, common bile duct (CBD) or main pancreatic duct (MPD) dilatation, vascular invasion, lymph node enlargement, DWI, and ADC value. Imaging findings associated with recurrence and disease-free survival (DFS) were assessed using logistic regression analysis and Cox proportional hazard regression analysis.

Results

The median follow-up period was 40.4 months, and recurrence after surgery occurred in 12.1% (12/99). Among them, 6 patients experienced recurrence within 1 year, and 9 patients experienced recurrence within 2 years after surgery. In multivariate analysis, major venous invasion (OR 10.76 [1.14–101.85], p = 0.04) was associated with recurrence within 1 year, and portal phase iso- to hypoenhancement (OR 51.89 [1.73–1557.89], p = 0.02), CBD or MPD dilatation (OR 10.49 [1.35–81.64], p = 0.03) and larger size (OR 1.05 [1.00–1.10], p = 0.046) were associated with recurrence within 2 years. The mean DFS was 116.4 ± 18.5 months, and the 5-year DFS rate was 85.7%. In multivariate analysis, portal phase iso- to hypoenhancement (HR 21.36 [2.01–197.77], p = 0.01), ductal dilatation (HR 5.22 [1.46–18.68], p = 0.01), major arterial invasion (HR 42.90 [3.66–502.48], p = 0.003), and larger size (HR 1.04 [1.01–1.06], p = 0.01) showed a significant effect on poor DFS.

Conclusion

MRI features, including size, enhancement pattern, vascular invasion, and ductal dilatation, are useful in predicting recurrence and poor DFS after surgery in PNET.
Key Points
MRI features are useful for predicting prognosis in patients with PNET after surgery.
PV or SMV invasion (OR 10.49 [1.35–81.64], p = 0.04) was significantly associated with 1-year recurrence.
Portal phase iso- to hypoenhancement (HR 21.36), CBD or MPD dilatation (HR 5.22), arterial invasion (HR 42.90), and larger size (HR 1.04) had significant effects on poor DFS (p < 0.05).
Appendix
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Metadata
Title
Prediction of recurrence after surgery based on preoperative MRI features in patients with pancreatic neuroendocrine tumors
Authors
Seungchul Han
Jung Hoon Kim
Jeongin Yoo
Siwon Jang
Publication date
01-04-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-021-08316-8

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