title: Neuroendocrine liver metastases: Vascular patterns on triple-phase MDCT are indicative of primary tumour location.
abstract: OBJECTIVE
  To re-evaluate and compare CT features of neuroendocrine liver metastases (NLM) from pancreatic (p) and enteric (e) gastroenteropancreatic (GEP) tumours.
  
  
  METHODS
  From 2006-2013, all patients with proven GEP-neuroendocrine tumours (NETs) with at least one NLM, no previous treatment were included. On unenhanced, arterial and portal phases, NLMs were characterized as hypo-, iso- or hyperattenuating in consensus by 2 radiologists blinded to clinical data. Enhancement patterns (EP) corresponded to the combination of arterial/portal CT attenuation.
  
  
  RESULTS
  78 patients (43 men, 55%, mean 56±13 yo) and 559NLMs were analyzed. pNLMs were more frequently hypoattenuating on unenhanced CT than eNLMs (72% vs. 57%, p<0.001). 70% of the lesions were hypervascular with no significant difference between pNLMs and eNLMs (p=0.32). eNLMs were more frequently hypoattenuating on portal phase than pNLMs (88% vs. 56%, p<0.001). eNLMs were more frequently hyper/hypo than pNLMs (56% vs. 28%, p<0.001). pNLMs were more frequently hyper/iso than eNLMs (33% vs. 8%, p<0.001). Other NLMs showed various patterns, including hypo/hypo in 12%.
  
  
  CONCLUSIONS
  Most NLMs of GEP tumours are hypervascular but the enhancement pattern on multiphasic CT depends on the primary tumour. These differences are helpful when the primary tumour has not been diagnosed.
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France; University Paris Diderot, Sorbonne Paris Cité, Paris, France; INSERM U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, Paris, France. Electronic address: maxime.ronot@aphp.fr.
authors.forename: Maxime
authors.initials: M
authors.lastname: Ronot
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cuccioli
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France.
authors.forename: Marco
authors.initials: M
authors.lastname: Dioguardi Burgio
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France.
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Vullierme
authors.affiliation: Department of Pancreatology, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France.
authors.forename: Olivia
authors.initials: O
authors.lastname: Hentic
authors.affiliation: University Paris Diderot, Sorbonne Paris Cité, Paris, France; Department of Pancreatology, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Ruszniewski
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France.
authors.forename: Gaspard
authors.initials: G
authors.lastname: d'Assignies
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France; University Paris Diderot, Sorbonne Paris Cité, Paris, France; INSERM U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, Paris, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000737:chemistry* / Q000556:secondary; D008113:Liver Neoplasms / Q000098:blood supply* / Q000473:pathology / Q000556:secondary; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D064847:Multimodal Imaging; D018358:Neuroendocrine Tumors / Q000098:blood supply* / Q000737:chemistry / Q000473:pathology / Q000556:secondary; D010190:Pancreatic Neoplasms / Q000737:chemistry* / Q000556:secondary; D013274:Stomach Neoplasms / Q000737:chemistry* / Q000556:secondary; D055815:Young Adult
keywords: Enhancement pattern; Gastroenteropancreatic; Hypervascular; Metastasis; Neuroendocrine tumour; Oncology; Primary tumour