Application of spectral CT combined with perfusion scan in diagnosis of pancreatic neuroendocrine tumors

Insights into Imaging - Tập 13 Số 1
Yamin Wan1, Hao He2, Yunjin Chen1, Yifan Zhang1, Qingmei Yue1
1Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Road, Zhengzhou, 450052, China
2Department of Radiology, Zhengzhou Central Hospital, Zhengzhou, 450000, China

Tóm tắt

Abstract Background Pancreatic neuroendocrine tumors (pNETs) are heterogeneous tumors from the pancreatic neuroendocrine system, and early diagnosis is important for tumor prognosis and treatment. In this study, we aimed to explore the diagnostic value of spectral CT combined with perfusion scanning in improving the detection rate of pNETs. Methods From December 2018 to December 2020, 58 patients with clinically suspected pNETs were prospectively enrolled in the study for one-stop spectral CT combined with perfusion scanning, 36 patients were confirmed with pNETs by histopathology. An independent cohort of 30 patients with pNETs who underwent routine pancreatic perfusion scanning in our hospital during the same period were retrospectively collected. The image characters of pNETs versus tumor-free pancreatic parenchymal were examined. Results The detection rate of spectral CT combined with perfusion was 83.1–96.2%. CT values of the pNETs lesions under each single energy in the arterial phase were statistically higher than those of the adjacent normal pancreatic parenchyma. IC, WC and NIC, in the arterial phase of pNETs lesion were all statistically higher than those of the adjacent normal pancreatic parenchyma. The perfusion parameters of pNETs including BF, BV and MSI were significantly higher than those in normal parenchyma. The average effective radiation dose during the perfusion combined energy spectrum enhanced scanning process was 17.51 ± 2.18 mSv. Conclusion The one-stop spectral CT combined with perfusion scan improves the detection of pNETs according to morphological features, perfusion parameters and energy spectrum characters with a relatively small radiation dose.

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Tài liệu tham khảo

Jeune F, Taibi A, Gaujoux S (2020) Update on the surgical treatment of pancreatic neuroendocrine tumors. Scand J Surg 109(1):42–52

Kulke MH, Ruszniewski P, Van Cutsem E et al (2019) A randomized, open-label, phase 2 study of everolimus in combination with pasireotide LAR or everolimus alone in advanced, well-differentiated, progressive pancreatic neuroendocrine tumors: COOPERATE-2 trial. Ann Oncol 30(11):1846

Vaghaiwalla T, Keutgen XM (2020) Surgical management of pancreatic neuroendocrine tumors. Surg Oncol Clin N Am 29(2):243–252

Wang H, Lin Z, Li G et al (2020) Validation and modification of staging systems for poorly differentiated pancreatic neuroendocrine carcinoma. BMC Cancer 20(1):188

Belousova E, Karmazanovsky G, Kriger A et al (2017) Contrast-enhanced MDCT in patients with pancreatic neuroendocrine tumours: correlation with histological findings and diagnostic performance in differentiation between tumour grades. Clin Radiol 72(2):150–158

Salahshour F, Mehrabinejad MM, Zare Dehnavi A et al (2020) Pancreatic neuroendocrine tumors (pNETs): the predictive value of MDCT characteristics in the differentiation of histopathological grades. Abdom Radiol (NY) 45(10):3155–3162

Dromain C, Déandréis D, Scoazec JY et al (2016) Imaging of neuroendocrine tumors of the pancreas. Diagn Interv Imaging 97(12):1241–1257

Lee DW, Kim MK, Kim HG (2017) Diagnosis of pancreatic neuroendocrine tumors. Clin Endosc 50(6):537–545

Zhu L, Xue H, Sun H et al (2017) Insulinoma detection with MDCT: is there a role for whole-pancreas perfusion? AJR Am J Roentgenol 208(2):306–314

Lv P, Lin XZ, Li J, Li W, Chen K (2011) Differentiation of small hepatic hemangioma from small hepatocellular carcinoma: recently introduced spectral CT method. Radiology 259(3):720–729

Patel BN, Thomas JV, Lockhart ME, Berland LL, Morgan DE (2013) Single-source dual-energy spectral multidetector CT of pancreatic adenocarcinoma: optimization of energy level viewing significantly increases lesion contrast. Clin Radiol 68(2):148–154

Pelgrim GJ, van Hamersvelt RW, Willemink MJ et al (2017) Accuracy of iodine quantification using dual energy CT in latest generation dual source and dual layer CT. Eur Radiol 27(9):3904–3912

Choi TW, Kim JH, Yu MH, Park SJ, Han JK (2018) Pancreatic neuroendocrine tumor: prediction of the tumor grade using CT findings and computerized texture analysis. Acta Radiol 59(4):383–392

D’Onofrio M, Cingarlini S, Ortolani S et al (2017) Perfusion CT changes in liver metastases from pancreatic neuroendocrine tumors during everolimus treatment. Anticancer Res 37(3):1305–1311

Xue HD, Jin ZY, Liu W, Wang Y, Zhao WM (2006) Perfusion characteristics of normal pancreas and insulinoma on multi-slice spiral CT. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 28(1):68–70

Almeida RR, Lo GC, Patino M, Bizzo B, Canellas R, Sahani DV (2018) Advances in pancreatic CT imaging. AJR Am J Roentgenol 211(1):52–66

Yao JC, Phan AT, Hess K et al (2015) Perfusion computed tomography as functional biomarker in randomized run-in study of bevacizumab and everolimus in well-differentiated neuroendocrine tumors. Pancreas 44(2):190–197