DIGESTIVE NEUROENDOCRINE NEOPLASMS: COMPUTED TOMOGRAPHY EVALUATION AND PATHOLOGIC CORRELATIONS

Aim: Our study aims to correlate the enhancement curve (EC) types (obtained after contrast enhanced computed tomography) with tumor grading in case of digestive neuroendocrine neoplasms (NENs). Material and methods: Our retrospective analysis included 39 patients with digestive neuroendocrine tumors, evaluated in Iasi with multidetector computed tomography (MDCT) between January 2015 and September 2019, using noncontrast enhanced, arterial and portal venous phases; only 9 patients were evaluated using an intermediate-delayed phase (4 min). Along with the enhancement curve (EC) pattern we evaluated also patient demographics, lesion location, dimensions, homogeneity, presence of calcifications and in case of malignant lesions: local extension, distant and regional lymph nodes metastases. Results: The most common location of neuroendocrine neoplasms included in the study was the pancreas (27 cases, 69.23%), followed by the mesentery (6 patients, 15.38%), small bowel (4 patients, 10.25%) and stomach (2 patients, 5.13%). The lesions had the following EC patterns: 27 (69.23%) cases wash-out EC type, 10 cases (25.65%) progressive EC, 2 cases (5.12%) plateau EC. Malignant lesions were found in 9 cases (23.07%) and all had wash-out type EC in the portal venous and intermediate-delayed phases. Conclusions: When appropriately combined with other CT features (dimensions, structure, noncontrast CT, arterial, portal venous and intermediate-delayed phases) the enhancement curve types have potential utility in positive diagnosis of digestive neuroendocrine tumors and in differentiating between malignant and benign lesions.