title: Contrast enhancement pattern on multidetector CT predicts malignancy in pancreatic endocrine tumours.
abstract: OBJECTIVE
  Preoperative suspicion of malignancy in pancreatic neuroendocrine tumours (pNETs) is mostly based on tumour size. We retrospectively reviewed the contrast enhancement pattern (CEP) of a series of pNETs on multiphasic multidetector computed tomography (MDCT), to identify further imaging features predictive of lesion aggressiveness.
  
  
  METHODS
  Sixty pNETs, diagnosed in 52 patients, were classified based on CEP as: type A showing early contrast enhancement and rapid wash-out; type B presenting even (B1) or only (B2) late enhancement. All tumours were resected allowing pathologic correlations.
  
  
  RESULTS
  Nineteen pNETs showed type A CEP (5-20 mm), 29 type B1 CEP (5-80 mm) and 12 type B2 (15-100 mm). All tumours were classified as well differentiated tumours, 19 were benign (WDt-b), 15 with uncertain behaviour (WDt-u) and 26 carcinomas (WDC). None of A lesions were malignant (12 WDt-b; 7 WDt-u), all B2 lesions were WDC, 7 B1 lesions were WDt-b, 8 WDt-u and 14 WDC; 4/34 (12 %) lesions ≤2cm were WDC. CEP showed correlation with all histological prognostic indicators.
  
  
  CONCLUSIONS
  Correlating with the lesion grading and other histological prognostic predictors, CEP may preoperatively suggest the behaviour of pNETs, assisting decisions about treatment. Moreover CEP allows recognition of malignant small tumours, incorrectly classified on the basis of their dimension.
authors.affiliation: Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy, carlacappelli1@gmail.com.
authors.forename: Carla
authors.initials: C
authors.lastname: Cappelli
authors.forename: Ugo
authors.initials: U
authors.lastname: Boggi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Mazzeo
authors.forename: Rosa
authors.initials: R
authors.lastname: Cervelli
authors.forename: Daniela
authors.initials: D
authors.lastname: Campani
authors.forename: Niccola
authors.initials: N
authors.lastname: Funel
authors.forename: Benedetta Pontillo
authors.initials: BP
authors.lastname: Contillo
authors.forename: Carlo
authors.initials: C
authors.lastname: Bartolozzi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media