The evolving role of imaging for small bowel neuroendocrine neoplasms: estimated impact of imaging and disease-free survival in a retrospective observational study

Sarasa Kim, Roy Marcus, Michael L. Wells, Shannon Sheedy, Stephanie L. Hansel, David H. Bruining, John M Barlow, Rickey E. Carter, Yong S. Lee, Matthew P. Johnson, Jeff Lynn Fidler, Ajit H. Goenka, Cynthia H. McCollough, Joel G. Fletcher

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To determine how small bowel neuroendocrine neoplasms (SBNEN’s) are diagnosed and examine the effect of CT enterography (CTE) on diagnosis and rates of disease-free survival. Methods: Histopathologically-confirmed SBNEN’s diagnosed at our institution between 1996 and 2016 were identified. Clinical presentation, radiology, endoscopy, surgery, and pathology reports were reviewed and compared between consecutive 5-year periods. Results: Of the 178 SBNEN initially diagnosed at our institution, the incidence increased 12-fold from 9 (during 1996–2000) to 114 (during 2011–2016). Comparing the first 5 to the last 5 years, GI bleeding and abdominal pain increased significantly as indications (with both increasing from 0 to > 25%, p ≤ 0.023). Initial diagnosis by radiology increased 2-fold [from 33% (n = 3) to 66% (n = 75); p = 0.263]. Detection of a small bowel mass and the suggestion that SBNEN was present varied significantly between imaging modalities (p < 0.0001; CTE − 95% (52/55) and 91% (50/55) vs. abdominal CT 45% (37/85) and 35% (29/85), respectively). Recurrence rates increased with SBNEN size (p = 0.012; e.g., of SBNEN diagnosed by endoscopy, 18% of SBNEN measuring 0.6 ± 0.3 cm recurred vs. 75% measuring 3.7 ± 1.0 cm). Rates of disease-free survival, and the incidence of local and liver metastases were decreased when tumors were first identified by CTE rather than other CT/MR imaging modalities (p = 0.0034, 0.0475, and 0.0032, respectively). Conclusion: There has been a dramatic increase in SBNENs detected by CTE and endoscopy over the last 20 years. SBNEN’s detected by CTE and small tumors detected at endoscopy have longer disease-free survival after surgical resection.

Original languageEnglish (US)
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Jan 1 2020

Keywords

  • Abdominal neoplasms
  • Computed tomography, X-Ray
  • Endoscopy, Gastrointestinal
  • Intestine, Small

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Fingerprint Dive into the research topics of 'The evolving role of imaging for small bowel neuroendocrine neoplasms: estimated impact of imaging and disease-free survival in a retrospective observational study'. Together they form a unique fingerprint.

Cite this