Diagnostic performance of multidetector computed tomography [MDCT] for differentiating between pancreatic adenocarcinoma and non-benign pancreatic neuroendocrine tumor

Objective: To evaluate the accuracy, sensitivity, and specificity of various abdominal computed tomography [CT] features in differentiating between pancreatic adenocarcinoma [PAC] and non-benign pancreatic neuroendocrine tumor [nPET]. Materials and Methods: Sixty-seven patients with pathologically confirmed PAC (n = 49) and nPET (n = 18) who had undergone preoperative abdominal CT were enrolled for this retrospective review. Imaging features on abdominal CT were analyzed. Sensitivity, specificity, positive, and negative predictive value of each significant variable (p-value of less than 0.05) were calculated. Results: Tumor location, demarcation, calcification, vascularity, bile duct dilatation, liver metastasis, adjacent organ invasion, and lymphadenopathies, were CT features for distinguish between the two groups in the univariate analysis. Tumor attenuation values on non-contrast, arterial phase, and portal venous phase [PVP], and tumor-to-pancreas contrast during arterial and PV phases of PAC were significantly lower than of nPET. In the multivariate analysis, an ill-defined margin, hypo/isovascularity, and absence of liver metastasis, were indicative of PAC than nPET. Conclusion: Abdominal CT is the reliable method to differentiate between PAC and nPET.