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Differentiation between pancreatic metastases from clear cell renal cell carcinoma and pancreatic neuroendocrine tumor using double-echo chemical shift imaging

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Abstract

Purpose

The purpose of the study was to retrospectively analyze whether double-echo gradient-echo (GRE) chemical shift imaging (CSI) can differentiate between pancreatic metastases from clear cell renal cell carcinoma (PM-ccRCC) and pancreatic neuroendocrine tumor (pNET).

Methods

Institutional review board approval and informed consent were waived. CSI, T2WI, DWI, and DCE magnetic resonance imaging (MRI) were performed in patients with PM-ccRCC and pNET. Eleven patients with PM-ccRCC and 24 patients with pNET were enrolled into this retrospective study. The signal intensity was measured in the pancreatic tumor and spleen on in-phase and opposed-phase images. The signal intensity index (SII) and tumor-to-spleen ratio (TSR) in PM-ccRCC and pNET were calculated and compared. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic accuracy of SII and TSR in the differentiation between PM-ccRCC and pNET.

Results

The SII between PM-ccRCC and pNET (20.3% ± 16.8% vs. − 3.2% ± 11.4%) was significantly different (P < 0.001), as was the TSR (− 19.2% ± 16.6% vs. 6.0% ± 13.8%) (P < 0.001). The area under the ROC curve was 0.917 for the SII and 0.902 for the TSR. Additionally, an SII threshold value of 8.1% permitted the differentiation of PM-ccRCC from pNET with a sensitivity of 90.9%, a specificity of 91.7%, a positive predictive value of 90.1%, a negative predictive value of 91.7%, and an accuracy of 91.4%. A TSR cut-off value of − 4.7% enabled the differentiation of the two groups with a sensitivity of 79.2%, a specificity of 90.9%, a positive predictive value of 90.9%, a negative predictive value of 79.2% and an accuracy of 82.9%.

Conclusion

Double-echo GRE chemical shift MR imaging can accurately differentiate between PM-ccRCC and pNET.

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Authors and Affiliations

  1. Department of Radiology, Shengli Oilfield Central Hospital, No. 31 Jinan Road, Dongying District, Dongying, 257034, Shandong Province, China

    Hai-lian Lyu

  2. Department of Radiology, Beijing Nuclear Industry Hospital, No. 2 Sanlihe Road, Xicheng District, Beijing, 100045, China

    Jian-xia Cao

  3. Department of Radiology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Hai-yi Wang, Lu Ma, Ying-wei Wang & Hui-yi Ye

  4. Department of Pathology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Zhan-bo Wang

  5. Department of Hepatobiliary Surgery, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Ming-gen Hu

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  1. Hai-lian Lyu
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Correspondence to Hai-yi Wang.

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Funding

This study was supported by National Natural Science Foundation of China (Grant No. 81471641).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Lyu, Hl., Cao, Jx., Wang, Hy. et al. Differentiation between pancreatic metastases from clear cell renal cell carcinoma and pancreatic neuroendocrine tumor using double-echo chemical shift imaging. Abdom Radiol 43, 2712–2720 (2018). https://doi.org/10.1007/s00261-018-1539-7

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