Computed tomography features in prediction of histological differentiation of pancreatic neuroendocrine neoplasms – a single-centre retrospective cohort stud

Purpose The aim of our study was to analyse the histological differentiation and computed tomography imaging features of pancreatic neuroendocrine neoplasms (PNENs). Material and methods We performed a retrospective single-centre cohort study of 157 patients with histologically confirmed PNEN. We compared the results of the preoperative biopsy from the tumour with reports of the multi-slice computed tomography performed by a radiologist with 30 years of clinical practice. Results Specific computed tomography (CT) features are associated with histological differentiation, such as enhancement in the arterial phase (p = 0.032), Wirsung’s duct dilatation (p = 0.001), other organ infiltration (p < 0.001), distant metastases (p < 0.001), and enlarged regional lymph nodes (p = 0.018). When there is an organ infiltration, the likelihood of the tumour having histological malignancy grades G2 or G3 triples (95% CI: 1.21-8.06). Likewise, the existence of distant metastases increases the risk almost fourfold (95% CI: 1.44-10.61), and a tumour size of 2 cm or larger is linked to a nearly threefold rise in the risk of histological malignancy grades G2 or G3 (95% CI: 1.21-6.24). Conclusions Certain CT characteristics: enhancement during the arterial phase, Wirsung’s duct dilatation, organ infiltration, distant metastases, and the enlargement of regional lymph nodes are linked to histological differentiation.