DIGESTIVE NEUROENDOCRINE NEOPLASMS: COMPUTED TOMOGRAPHY EVALUATION AND PATHOLOGIC CORRELATIONS

  • Irina JARI “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Liliana GHEORGHE “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • D. NEGRU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Irina FLOREA “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Manuela URSARU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Paloma HORJINEC “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Carmen-Georgiana PITUSAC-PRISACARU “Sf. Spiridon” County Clinical Emergency Hospital Iasi
  • A. G. NAUM “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Abstract

Aim: Our study aims to correlate the enhancement curve (EC) types (obtained after contrast enhanced computed tomography) with tumor grading in case of digestive neuroendocrine neoplasms (NENs). Material and methods: Our retrospective analysis included 39 patients with digestive neuroendocrine tumors, evaluated in Iasi with multidetector computed tomography (MDCT) between January 2015 and September 2019, using noncontrast enhanced, arterial and portal venous phases; only 9 patients were evaluated using an intermediate-delayed phase (4 min). Along with the enhancement curve (EC) pattern we evaluated also patient demographics, lesion location, dimensions, homogeneity, presence of calcifications and in case of malignant lesions: local extension, distant and regional lymph nodes metastases. Results: The most common location of neuroendocrine neoplasms included in the study was the pancreas (27 cases, 69.23%), followed by the mesentery (6 patients, 15.38%), small bowel (4 patients, 10.25%) and stomach (2 patients, 5.13%). The lesions had the following EC patterns: 27 (69.23%) cases wash-out EC type, 10 cases (25.65%) progressive EC, 2 cases (5.12%) plateau EC. Malignant lesions were found in 9 cases (23.07%) and all had wash-out type EC in the portal venous and intermediate-delayed phases. Conclusions: When appropriately combined with other CT features (dimensions, structure, noncontrast CT, arterial, portal venous and intermediate-delayed phases) the enhancement curve types have potential utility in positive diagnosis of digestive neuroendocrine tumors and in differentiating between malignant and benign lesions.

Author Biographies

Irina JARI, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Surgery (II)

Liliana GHEORGHE, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Surgery (II)

D. NEGRU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Surgery (II)

Irina FLOREA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Morpho-functional Sciences (I)

Manuela URSARU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Surgery (II)

Paloma HORJINEC, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)

A. G. NAUM, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Morpho-functional Sciences (I)

References

1. Klimstra DS, Kloppel G, La Rosa S, Rindi G. Classification of the Neuroendocrine neoplasms of the Digestive System / WHO Classification of Tumors, 5th edition, Lyon, IARC Publishing House, 2019, 16-22.
2. Oronsky B, Ma PC, Morgensztern D, Carter OC. Nothing But NET: A Review of Neuroendocrine Tumors and Carcinomas. Neoplasia 2017; 19(12): 991-1002.
3. Rindi G, Klimstra DS, Abedi-Ardekani B, et al. A common classification framework for neuroendo-crine neoplasms: an International Agency for Research on Cancer (IARC) and World Health Organi-zation (WHO) expert consensus proposal. Mod Pathol 2018; 31(12): 1770-1786.
4. Zerunian M, Bellini D, Laghi A. Role of Non-Functional Imaging in the Diagnosis of Abdominal Neuroendocrine Tumors. In: Abdominal Neuroendocrine Tumors. Carlini M editor. Milan: Springer, 2018, 91-108.
5. Scarpa Bartscha DK, Scherüblb H. Neuroendocrine Tumors of the Gastrointestinal Tract. Visc Med. 2017; 33: 321-322.
6. Henderson-Jackson E, et al. Neuroendocrine Neoplasm of the Stomach. In: Coppola D editor. Neuro-endocrine Tumors: Review of Pathology, Molecular and Therapeutic Advances, New York, Springer, 2016, 218-221.
7. Pleşa A, Sarca E, Maxim R. Metastatic carcinoid tumor-atypical presentation. Rev Med Chir Soc Med Nat Iasi 2014; 118(4): 1018-1023.
8. Severi S, Paganell G. Role of Functional Imaging in the Diagnosis of Neuroendocrine Tumors. In: Abdominal Neuroendocrine Tumors. Carlini M editor. Milan: Springer, 2018, 109-122.
9. Yao JC, et al. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuro-endocrine tumors in 35,825 cases in the United States. Journal of Clinical Oncology 2008; 26(18): 3063-3072.
10. Modlin IM, et al. Gastroenteropancreatic neuroendocrine tumors. The Lancet Oncology 2008; 9(1): 61-72.
11. Sundin A, et al. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: radiological examinations. Neuroendocrinology 2009; 90(2): 167-183.
12. Chiti A, et al. Comparison of somatostatin receptor imaging, computed tomography and ultrasound in the clinical management of neuroendocrine gastro-entero-pancreatic tumors. European Journal of Nuclear Medicine 1998; 25(10): 1396-1403.
13. Frilling A, Akerström G, Falconi M, et al. Neuroendocrine tumor disease: an evolving landscape. Endocr Relat Cancer 2012; 19(5): R163-185.
14. Hauso O, et al. Neuroendocrine Tumor Epidemiology Contrasting Norway and North America. Cancer 2008; 113: 2655-2664.
15. Lawrence B, Gustafsson BI, Chan A, Svejda B, Kidd M, Modlin IM. The epidemiology of gastro-entero-pancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am 2011; 40(1): 1-18.
16. Maxwell JE, Howe JR. Imaging in neuroendocrine tumors: an update for the clinician. International Journal 2015; 2(2): 159-168.
17. Lee, Joseph KT, ed. Computed body tomography with MRI correlation. Vol. 1. Lippincott Williams & Wilkins, 2006.
Published
2020-09-30