Journal of endocrinological investigation · 2026
Diffusion-weighted magnetic resonance imaging as a promising technique for detection and follow-up of liver metastases from neuroendocrine tumors: a retrospective and prospective study from the NETTARE task force.
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Feola Tiziana, Sesti Franz, Filice Alessia, Nistor Alexandra, Valenti Alessandra, Puliani Giulia, Centello Roberta, Pandozzi Carla, Gagliardi Arianna, Pirisino Riccardo, Bagni Oreste, Salducci Mauro, Appetecchia Marialuisa, Catalano Carlo, Isidori Andrea M, Maccioni Francesca, Giannetta Elisa
Аннотация
BACKGROUND: A combination of morphological and functional imaging plays a crucial role for neuroendocrine tumors (NETs) management. Diffusion-weighted magnetic resonance imaging (DWI-MRI) is an emerging key imaging technique in the NET field.
AIM: to evaluate the diagnostic and prognostic role of DWI-MRI in liver metastases (LMs) from NETs compared with multiparametric MRI and functional imaging with 68Ga-DOTA peptides positron emission tomography (PET)-computed tomography (CT).
METHODS: This is a monocentric, observational, both retrospective and prospective study including patients with histologically proven diagnosis of gastroenteropancreatic (GEP) NET with LM evaluated with MRI and 68Ga-DOTA peptides PET-CT, performed within 6 months apart at diagnosis or follow-up. We collected clinical, pathological, imaging data including lesions number detected on (a)MRI-gold standard, (b)DWI images, (c)68Ga-DOTA peptides PET-CT. Apparent diffusion coefficient (ADC) was calculated on target lesions.
RESULTS: 426 LMs were analyzed from 17 patients (11 males, mean age 57.2 ± 12.6 years) meeting the inclusion criteria (11.8% G1, 64.7% G2, and 23.5% G3); MRI detected a median of 15 (IQR 2.5-40) lesions per patient, DWI 15 (IQR 2.5-36.5) lesions, while PET-CT 6 (IQR 2.5-20) lesions. Non-parametric analyses suggested that DWI had a detection rate comparable to MRI (p = 0.068) and superior to 68Ga-DOTA peptides PET-CT (p = 0.004), whereas mixed-effects modelling accounting for within-patient clustering showed no statistically significant pairwise differences between imaging modalities after multiple-comparison correction. Moderate-to-good consistency in lesion burden estimation across imaging modalities supported the reproducibility of lesion quantification. Correlation analyses suggested MRI lesion load may reflect the aggressiveness of disease.
CONCLUSIONS: DWI-MRI can be a useful time-saving imaging technique in the diagnosis and follow-up of LMs from NETs, with a potentially favorable cost-effectiveness ratio.
AIM: to evaluate the diagnostic and prognostic role of DWI-MRI in liver metastases (LMs) from NETs compared with multiparametric MRI and functional imaging with 68Ga-DOTA peptides positron emission tomography (PET)-computed tomography (CT).
METHODS: This is a monocentric, observational, both retrospective and prospective study including patients with histologically proven diagnosis of gastroenteropancreatic (GEP) NET with LM evaluated with MRI and 68Ga-DOTA peptides PET-CT, performed within 6 months apart at diagnosis or follow-up. We collected clinical, pathological, imaging data including lesions number detected on (a)MRI-gold standard, (b)DWI images, (c)68Ga-DOTA peptides PET-CT. Apparent diffusion coefficient (ADC) was calculated on target lesions.
RESULTS: 426 LMs were analyzed from 17 patients (11 males, mean age 57.2 ± 12.6 years) meeting the inclusion criteria (11.8% G1, 64.7% G2, and 23.5% G3); MRI detected a median of 15 (IQR 2.5-40) lesions per patient, DWI 15 (IQR 2.5-36.5) lesions, while PET-CT 6 (IQR 2.5-20) lesions. Non-parametric analyses suggested that DWI had a detection rate comparable to MRI (p = 0.068) and superior to 68Ga-DOTA peptides PET-CT (p = 0.004), whereas mixed-effects modelling accounting for within-patient clustering showed no statistically significant pairwise differences between imaging modalities after multiple-comparison correction. Moderate-to-good consistency in lesion burden estimation across imaging modalities supported the reproducibility of lesion quantification. Correlation analyses suggested MRI lesion load may reflect the aggressiveness of disease.
CONCLUSIONS: DWI-MRI can be a useful time-saving imaging technique in the diagnosis and follow-up of LMs from NETs, with a potentially favorable cost-effectiveness ratio.