Textural analysis on contrast-enhanced CT in pancreatic neuroendocrine neoplasms: association with WHO grade
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Grades of pancreatic neuroendocrine neoplasms (PNENs) are associated with the choice of treatment strategies. Texture analysis has been used in tumor diagnosis and staging evaluation. In this study, we aim to evaluate the potential ability of texture parameters in differentiation of PNENs grades.
Materials and methods
37 patients with histologically proven PNENs and underwent pretreatment dynamic contrast-enhanced computed tomography examinations were retrospectively analyzed. Imaging features and texture features at contrast-enhanced images were evaluated. Receiver operating characteristic curves were used to determine the cut-off values and the sensitivity and specificity of prediction.
There were significant differences in tumor margin, pancreatic duct dilatation, lymph nodes invasion, size, portal enhancement ratio (PER), arterial enhancement ratio (AER), mean grey-level intensity, kurtosis, entropy, and uniformity among G1, G2, and pancreatic neuroendocrine carcinoma (PNEC) G3 (p < 0.01). Similar results were found between pancreatic neuroendocrine tumors (PNETs) G1/G2 and PNEC G3. AER and PER showed the best sensitivity (0.86–0.94) and specificity (0.92–1.0) for differentiating PNEC G3 from PNETs G1/G2. Mean grey-level intensity, entropy, and uniformity also showed acceptable sensitivity (0.73–0.91) and specificity (0.85–1.0). Mean grey-level intensity was also showed acceptable sensitivity (91% to 100%) and specificity (82% to 91%) in differentiating PNET G1 from PNET G2.
Our data indicated that texture parameters have potential in grading PNENs, in particular in differentiating PNEC G3 from PNETs G1/G2.
KeywordsPancreatic neuroendocrine neoplasms Grade Pancreatic neuroendocrine carcinoma Texture analysis Computed tomography
Compliance with ethical standards
This study was supported by the Zhejiang Medical Science and Technology Project (2017KY331) and Primary Research & Development Plan of Jiangsu Province (BE2017772).
The authors do not have any possible conflicts of interest.
This retrospective study was approved by the Institutional Review Board of the First Affiliated Hospital, College of Medicine Zhejiang University. For this retrospective study, the requirement of the formal consent was waived.
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