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Abdom Imaging. 2013 Apr;38(2):358-66. doi: 10.1007/s00261-012-9953-8.

Pancreatic neuroendocrine neoplasm: correlation between computed tomography enhancement patterns and prognostic factors of surgical and endoscopic ultrasound-guided fine-needle aspiration biopsy specimens.

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  • 1Department of Radiology, Teine Keijinkai Hospital, 1-12-1-40 Maeda Teine-ku, Sapporo, Hokkaido, 006-8555, Japan.

Abstract

PURPOSE:

To retrospectively determine whether enhancement patterns in the pancreatic and equilibrium phases of computed tomography (CT) for pancreatic neuroendocrine neoplasms are related to prognostic factors of surgical and endoscopic ultrasound-guided fine-needle aspiration biopsy specimens.

METHODS:

Twenty-five pancreatic neuroendocrine neoplasms in 22 patients underwent preoperative dynamic CT. Tumors were classified into two groups by enhancement patterns on preoperative CT. A washout pattern was defined as peak enhancement in the pancreatic phase with washout of at least 60 Hounsfield units in the equilibrium phase. Group 1 comprised tumors showing a washout pattern in more than half of tumor and Group 2 comprised tumors showing a washout pattern in less than half of the tumor. The Ki-67 index and the presence of vascular invasion were evaluated in surgical specimens. The Ki-67 index from biopsy specimens was compared with that from surgical specimens.

RESULTS:

There were 12 surgical specimens in Group 1 and 13 in Group 2. Group 2 showed significant correlations with larger Ki-67 indices (p < 0.05) and positive vascular invasion (p < 0.05). The Ki-67 index discrepancy between biopsy and surgical specimens of Group 2 was significantly greater than that of Group 1 (p < 0.05).

CONCLUSIONS:

Pancreatic neuroendocrine neoplasms in which less than half of the tumor showed a washout pattern were correlated with poor prognostic factors. Analysis of enhancement patterns may provide predictive information about whether endoscopic ultrasound-guided fine-needle aspiration biopsy is reliable for the assessment of Ki-67 index.

[PubMed - indexed for MEDLINE]
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