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Diagnostic Performance of Multidetector Computed Tomography [MDCT] for Differentiating between Pancreatic Adenocarcinoma and Non-Benign Pancreatic Neuroendocrine Tumor

Sopa Pongpornsup MD1, Janejira Chumcheon MD1, Aphinya Charoensak MD1

Affiliation : 1 Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand


Objective : To evaluate the accuracy, sensitivity, and speci(cid:976)icity of various abdominal computed tomography [CT] features in differentiating between pancreatic adenocarcinoma [PAC] and non-benign pancreatic neuroendocrine tumor [nPET].
Materials and Methods : Sixty-seven patients with pathologically con(cid:976)irmed PAC (n = 49) and nPET (n = 18) who had undergone preoperative abdominal CT were enrolled for this retrospective review. Imaging features on abdominal CT were analyzed. Sensitivity, speci(cid:976)icity, positive, and negative predictive value of each signi(cid:976)icant variable (p-value of less than 0.05) were calculated.
Results : Tumor location, demarcation, calci(cid:976)ication, vascularity, bile duct dilatation, liver metastasis, adjacent organ invasion, and lymphadenopathies, were CT features for distinguish between the two groups in the univariate analysis. Tumor attenuation values on non-contrast, arterial phase, and portal venous phase [PVP], and tumor-to-pancreas contrast during arterial and PV phases of PAC were signi(cid:976)icantly lower than of nPET. In the multivariate analysis, an ill-de(cid:976)ined margin, hypo/isovascularity, and absence of liver metastasis, were indicative of PAC than nPET.
Conclusion : Abdominal CT is the reliable method to differentiate between PAC and nPET.

Keywords : Pancreas, Pancreatic adenocarcinoma, Non-benign pancreatic neuroendocrine tumor, Abdominal computed tomography


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