Neuroendocrine tumors of stomach and pancreas: diagnostic potential of radiomics, issues, and solutions

Abstract

BACKGROUND: Radiomics is currently a promising and prospective tool for diagnosing and treating neuroendocrine neoplasms at various sites. This method is often used for differential diagnosis of gastrointestinal neuroendocrine tumors with other neoplasms at this site.

AIM: The aim of the study was to evaluate the potential of radiomics for differential diagnosis of neuroendocrine tumors of stomach and pancreas.

MATERIALS AND METHODS: The study included data of 12 patients with morphologically proven neoplasms of the stomach (6 with neuroendocrine tumors and 6 with adenocarcinomas) and data of 22 patients with morphologically proven neoplasms of the pancreas (11 with neuroendocrine tumors and 11 with adenocarcinomas). All patients underwent abdominal computed tomography (CT) with intravenous contrast enhancement prior to treatment at the Russian Scientific Center of Roentgenology and Radiology. Radiomics parameters were calculated for the area of gastric and pancreatic tumor manually segmented in the native phase of the CT scan. The results were processed and statistically analyzed using Microsoft Office Excel and R-Studio, a free, open-source software development environment for the R programming language.

RESULTS: CT scan examples demonstrate typical and atypical visual signs of neuroendocrine tumors of stomach and pancreas, contrast enhancement characteristics, location and structure of neoplasms. Fifteen radiomics parameters were identified that were statistically significantly different between gastric neuroendocrine tumor and gastric adenocarcinoma. In pancreas, neuroendocrine tumors differed significantly from adenocarcinomas in 14 radiomics parameters.

CONCLUSIONS: Neuroendocrine tumors of stomach and pancreas are rare neoplasms that are mostly asymptomatic and difficult to visualize due to their small size and contrast enhancement characteristics. Texture analysis may be a promising approach to differentiate gastrointestinal neuroendocrine tumors from other neoplasms at these sites, especially in the view of the difficulty in obtaining a biopsy.

Keywords

neuroendocrine tumor / neuroendocrine tumor of stomach / neuroendocrine tumor of pancreas / neuroendocrine neoplasia / radiology

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