Open AccessThe MRI-Hallmarks of Liver Neroendocrine Metastases with Different Localization of Primary Neroendocrine Tumor
Author(s) -
М. Г. Лаптева,
Olga Sergeeva,
М. А. Шориков,
Е. А. Колосов,
Е. В. Тарачкова,
В. А. Горбунова,
Б. И. Долгушин
Publication year - 2020
Publication title -
onkologičeskij žurnal: lučevaâ diagnostika, lučevaâ terapiâ
Language(s) - English
Resource type - Journals
eISSN - 2713-167X
pISSN - 2587-7593
DOI - 10.37174/2587-7593-2020-3-4-39-50
Subject(s) - medicine , stomach , magnetic resonance imaging , gastrointestinal tract , washout , metastasis , nuclear medicine , radiology , pathology , gastroenterology , cancer
Purpose: To identify the MRI-hallmarks of liver metastatic neuroendocrine tumors (mNETs) with different localization of primary tumor. Material and methods: 75 liver mNET patients were enrolled in the study. The hepatic metastasis patients were divided into two groups: with pancreatic mNETs (n = 37) and with gastrointestinal tract (gut) mNETs (n = 38), including those of a stomach, small and large bowel, and appendicular primary. All patients underwent abdominal contrast-enhanced MRI with the measurement: the number and the maximum size of the lesions, the presence and size of avascular zones in the lesions, the presence of MRI signs of hemoglobin deg-radation products. In the region of interest, which corresponded to a rounded section in the solid portions of metastases, were measured quantitative indicators of signal intensity on T 2 -weighted images (WI), native and post-contrast T 1 -WI, the degree of accumulation of MR contrast agent (MRCA) and its washout, the value of apparent diffusion coefficient (ADC). A total of 171 lesions were assessed. The data were compared in the varying localization of the primary NET groups of patients. Results: The study demonstrated that the solid portion of the gut mNETs compared with that of the pancreatic mNETs are characterized by lower ADC-value (p = 0.0102, medians: pancreatic mNETs — 1036 × 10 –3 mm 2 /s, gut mNETs — 846 × 10 –3 mm 2 /s), less active accumulation of MRCA on the arterial (p = 0.0002, medians: pan-creatic mNETs — 1.48, gut mNETs — 1.24) and venous (p = 0.0026, median: pancreatic mNETs — 2.22, gut mNETs — 1.9) phases of contrast enhancement, longer washout of MRCA (p = 0.0057, median: pan-creas mNETs — 0.92, gut mNETs — 0.98). Based on regression-factor analysis, a model for determining the localization of primary tumors based on MRI signs of liver mNETs was created with an accuracy of 93.8 %. Conclusion: Gut mNETs compared with that of the pancreatic mNETs are characterized by lower ADC-value, less active accumulation and longer washout of MRCA. The data can be used to draw up a personalized examination plan of patient with liver mNETs from the unknown primary.