Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2023; 15(12): 2809-2819
Published online Dec 27, 2023. doi: 10.4240/wjgs.v15.i12.2809
Prediction of the lymphatic, microvascular, and perineural invasion of pancreatic neuroendocrine tumors using preoperative magnetic resonance imaging
Yu-Liang Liu, Hai-Bin Zhu, Mai-Lin Chen, Wei Sun, Xiao-Ting Li, Ying-Shi Sun
Yu-Liang Liu, Hai-Bin Zhu, Mai-Lin Chen, Xiao-Ting Li, Ying-Shi Sun, Department of Radiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
Wei Sun, Department of Pathology, Peking University Cancer Hospital and Institute, Beijing 100142, China
Co-first authors: Yu-Liang Liu and Hai-Bin Zhu.
Author contributions: Liu YL and Zhu HB contributed equally to this work; Sun YS, Liu YL, Zhu HB, and Chen ML contributed to the conception and design of the research study, they contributed to the administrative support; Liu YL, Zhu HB, Chen ML, and Sun W provide the study materials or patients; Liu YL, Zhu HB, and Chen ML contributed to the collection and assembly of data; Liu YL, Zhu HB, and Li XT contributed to data analysis and interpretation; Liu YL and Zhu HB wrote the manuscript; and all authors have read and approve the final manuscript.
Supported by Beijing Hospitals Authority Youth Program, No. QML20231103.
Institutional review board statement: This study was conducted in accordance with the Declaration of Helsinki and was approved by the institutional review board of our hospital.
Informed consent statement: The requirement for informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying-Shi Sun, MD, Chief Physician, Professor, Department of Radiology, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. sys27@163.com
Received: October 7, 2023
Peer-review started: October 7, 2023
First decision: October 24, 2023
Revised: November 6, 2023
Accepted: December 6, 2023
Article in press: December 6, 2023
Published online: December 27, 2023
ARTICLE HIGHLIGHTS
Research background

Pancreatic neuroendocrine tumors (PNETs) are comparatively rare neoplasms. Lymphatic, microvascular, and perineural invasion (LMPI) was significantly correlated with the prognosis of PENTs which was confirmed by previous studies. There was no previous study reported the relationship between magnetic resonance imaging (MRI) parameters and LMPI.

Research motivation

The key problem is whether preoperative MRI of the pancreas can predict LMPI in patients with non-functioning NF-PNETs.

Research objectives

The main objective is to determine the feasibility to predict lymphatic, microvascular and perineural invasion in patients with non-functioning PENTs (NF-PNETs) by using preoperative MRI of the pancreas. MRI is a non-invasive imaging modality, and there will be more broad application prospects.

Research methods

The comprehensive clinical indicators and MRI parameters of patients with NF-PNETs were collected. A multivariate logistic regression model was established and the diagnostic performance was evaluated.

Research results

Patients were divided into two groups according to the LMPI state. Irregular margin (P < 0.001) and heterogeneous enhancement pattern (P = 0.011) were more likely to be seen in a patient with LMPI. The long axis of the largest lymph node was significantly larger (7.26 ± 5.27 vs 4.15 ± 3.29, P = 0.006) in patients with LMPI. According to the multivariate logistic regression analysis, tumor margin (odds ratio = 11.523; 95% confidence interval: 2.966-44.761, P < 0.001) was an independent factor associated with LMPI of NF-PNETs.

Research conclusions

The relationship between MRI features and LMPI of NF-PNETs was elaborated. The tumor margin, which is one of the MRI features, has an important role in predicting LMPI in patients with NF-PNETs.

Research perspectives

This study evaluated the relationship between preoperative clinical indicators, MRI parameters and LMPI in NF-PNETs. To evaluate the correlation between MRI features and lymphatic invasion, microvascular invasion and perineural invasion respectively.