Diagnostic imaging of gastrointestinal neuroendocrine tumours (GI-NETs): relationship between MDCT features and 2010 WHO classification

Radiol Med. 2019 Feb;124(2):94-102. doi: 10.1007/s11547-018-0946-8. Epub 2018 Sep 25.

Abstract

Aims: We aimed to present our series of gastrointestinal neuroendocrine tumours (GI-NETs) in order to illustrate and highlight the associated contrast-enhanced multi-detector computed tomography (MDCT) features. We also attempted to identify a relationship between MDCT imaging and the 2010 World Health Organization (WHO) classification system.

Materials and methods: We selected all patients with pathologically proven GI-NETs diagnosed between January 2010 and August 2017. Only patients undergone contrast-enhanced MDCT imaging in the immediate preoperative period were included in our study. Later, two expert radiologists retrospectively assessed MDCT intestinal and extra-intestinal signs. We also analysed the relationship between MDCT imaging and the 2010 WHO classification.

Results: A total of 20 patients (13 males, 7 females, age range 37-89 years, mean age 69.9 years) were included in our study. The majority of GI-NETs (85%) occurred in the small bowel and mainly in the terminal ileum. Forty-five percentage of our GI-NETs were diagnosed after an access to emergency medical service for obstruction symptoms or gastrointestinal bleeding. Regarding intestinal signs, 15/20 patients showed an intraluminal nodular mass and 5/20 a wall thickening. Extra-intestinal signs were present in 75% of cases. Desmoplastic reaction and lymph nodes metastases were significantly correlated with higher grade of GI-NETs.

Conclusions: The majority of GI-NETs appears as intraluminal mass often associated with extra-intestinal signs. We found a significantly correlation between higher grade of GI-NETs and extra-intestinal signs. MDCT imaging may be useful in predicting the pathological classification of GI-NETs.

Keywords: Extra-intestinal signs; Gastrointestinal neuroendocrine tumours; Intestinal signs; Multi-detector computed tomography; Pathological classification.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media
  • Female
  • Gastrointestinal Neoplasms / diagnostic imaging*
  • Gastrointestinal Neoplasms / pathology
  • Humans
  • Iohexol / analogs & derivatives
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neuroendocrine Tumors / diagnostic imaging*
  • Neuroendocrine Tumors / pathology
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*
  • World Health Organization

Substances

  • Contrast Media
  • Iohexol
  • iopromide