Preliminary study about the value of CT radiological features in predicting the pathological grade of neuroendocrine neoplasm liver metastases

XIE Tiansong; LIU Wei; SUN Jing; CHEN Lei; ZHOU Zhengrong

doi:10.19732/j.cnki.2096-6210.2026.02.011

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Preliminary study about the value of CT radiological features in predicting the pathological grade of neuroendocrine neoplasm liver metastases

Article | 更新时间：2026-05-07

- Preliminary study about the value of CT radiological features in predicting the pathological grade of neuroendocrine neoplasm liver metastases
- Oncoradiology Vol. 35, Issue 2, Pages: 309-318(2026)
- 作者机构：
  
  1.复旦大学附属肿瘤医院放射诊断科，复旦大学上海医学院肿瘤学系，上海 200032
  2.福建省肿瘤医院放射诊断科，福建医科大学肿瘤临床医学院，福建福州 350014
  3.复旦大学附属肿瘤医院闵行院区影像科，上海 200240
- 作者简介：
  
  ZHOU Zhengrong　E-mail: zhouzr-16@163.com
- 基金信息：
  
  General Program of National Natural Science Foundation of China(NSFC82471981);Shanghai Anti-Cancer Association Eyas Program(SACA-CY23B05);Shanghai Anti-Cancer Association Soar Program(SACA-AX202309);Xuhui District Hospital-Community Cooperation Project(23XHYD-13)
- DOI：10.19732/j.cnki.2096-6210.2026.02.011
  CLC： R735.7;R445.3
- Received：14 November 2025，
  
  Revised：2026-01-09，
  
  Published：28 April 2026
- 稿件说明：
移动端阅览
解添淞, 刘　伟, 孙　静, 等. CT放射学特征在评估神经内分泌肿瘤肝转移病理学级别上的价值初探［J］. 肿瘤影像学, 2026, 35(2): 309-318.

XIE T S, LIU W, SUN J, et alCitation:. Preliminary study about the value of CT radiological features in predicting the pathological grade of neuroendocrine neoplasm liver metastases［J］. Oncoradiology, 2026, 35(2): 309-318.
解添淞, 刘　伟, 孙　静, 等. CT放射学特征在评估神经内分泌肿瘤肝转移病理学级别上的价值初探［J］. 肿瘤影像学, 2026, 35(2): 309-318. DOI： 10.19732/j.cnki.2096-6210.2026.02.011.

XIE T S, LIU W, SUN J, et alCitation:. Preliminary study about the value of CT radiological features in predicting the pathological grade of neuroendocrine neoplasm liver metastases［J］. Oncoradiology, 2026, 35(2): 309-318. DOI： 10.19732/j.cnki.2096-6210.2026.02.011.

摘要

目的

探究计算机体层成像（computed tomography，CT）放射学特征在鉴别不同病理学级别的神经内分泌肿瘤（neuroendocrine neoplasm，NEN）肝转移灶上的可行性与价值。

方法

回顾并分析2021年7月—2025年4月复旦大学附属肿瘤医院的NEN肝转移患者的肝转移灶，其中G1/2级病变均由术后病理学检查证实，G3级病变由穿刺活检或术后病理学检查证实。评估肿瘤在增强CT上的定量和定性特征，分析G1/2级与G3级病变的CT放射学特征差异性，使用多因素分析筛选出对肿瘤病理学级别具有预测价值的CT特征。

结果

本研究共纳入67例NEN肝转移患者共计118枚肝转移灶，其中G1/2级72枚（61.0%），G3级46枚（39.0%）。G1/2级肝转移瘤在动脉早期、动脉晚期及静脉期的CT值均显著高于G3级肝转移瘤（均

0.001），肿瘤在动脉早期、动脉晚期及静脉期的CT值鉴别病理学级别的曲线下面积（are under curve，AUC）分别为0.713、0.714、0.681。在定性特征中，肿瘤的动脉血供、动态增强模式、囊泡征、肿瘤边缘在G1/2与G3级间差异均有统计学意义（

0.05）。多因素logistic分析表明，肿瘤血供、动态增强模式、肿瘤边缘和瘤内坏死是鉴别G1/2级和G3级NEN肝转移灶的独立预测因子，乏血供、缓慢上升型强化、肿瘤边缘模糊、瘤内广泛坏死提示G3级肝转移。

结论

CT放射学特征在无创鉴别G1/2级与G3级NEN肝转移中具有价值，有望为NEN肝转移的精准治疗提供帮助。

Abstract

Objective

To explore the feasibility and value of computed tomography (CT) radiological features in differentiating liver metastases of neuroendocrine neoplasms (NEN) with different pathological grades.

Methods

NEN patients with hepatic metastases treated at Fudan University Shanghai Cancer Center between July 2021 and April 2025 were retrospectively enrolled and analyzed. Among these cases

G1/G2 lesions were confirmed by surgical pathology

while G3 lesions were confirmed by either biopsy or surgical pathology. The quantitative and qualitative features of the tumors on enhanced CT were evaluated

the differences in CT radiological features between G1/2 and G3 lesions were analyzed

and multivariate analysis was used to identity CT features with predictive value for pathological grades.

Results

A total of 67 NEN patients with hepatic metastases (encompassing 118 hepatic metastatic lesions) were enrolled in this study. Among these lesions

(61.0%) were G1/G2

and 46 (39.0%) were G3. The CT values of G1/2 liver metastases in the early arterial phase

late arterial phase

and venous phase were significantly higher than those of G3 liver metastases (all

0.001). The areas under the curve (AUC) of CT values in the early arterial phase

late arterial phase

and venous phase for differentiating pathological grades were 0.713

0.714

and 0.681

respectively. Among qualitative features

there were significant differences in arterial blood supply

dynamic enhancement pattern

vesicle sign

and tumor margin between G1/2 and G3 grades (all

0.05). Multivariate logistic analysis showed that tumor blood supply

dynamic enhancement pattern

tumor margin

intra-tumoral necrosis were independent predictors for differentiating liver metastases of G1/2 and G3 NEN. Poor blood supply

slow-rising enhancement pattern

blurred tumor margin

and extensive intra-tumoral necrosis suggested G3 liver metastasis.

Conclusion

CT radiological features are valuable in non-invasive differentiation of G1/2 and G3 NEN liver metastases

and are expected to provide assistance for precise treatment of NEN liver metastases.

关键词

Keywords

references

DAS S , DASARI A . Epidemiology, incidence, and prevalence of neuroendocrine neoplasms: are there global differences? ［J］. Curr Oncol Rep , 2021 , 23 ( 4 ): 43 .

YAO J C , HASSAN M , PHAN A , et al . One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35 825 cases in the United States ［J］. J Clin Oncol , 2008 , 26 ( 18 ): 3063 - 3072 .

中国抗癌协会神经内分泌肿瘤专业委员会 . 中国抗癌协会神经内分泌肿瘤诊治指南（2022年版）［J］. 中国癌症杂志 , 2022 , 32 ( 6 ): 545 - 580 .

Society of Neuroendocrine Neoplasm of China Anti-Cancer Association . China Anti-Cancer Association guideline for diagnosis and treatment of neuroendocrine neoplasm (2022 edition) ［J］. China Oncol , 2022 , 32 ( 6 ): 545 - 580 .

SHARMA A , MURALITHARAN M , RAMAGE J , et al . Current management of neuroendocrine tumor liver metastases ［J］. Curr Oncol Rep , 2024 , 26 ( 9 ): 1070 - 1084 .

JOSEPH N M , UMETSU S E , KIM G E , et al . Progression of low-grade neuroendocrine tumors (NET) to high-grade neoplasms harboring the NEC-like co-alteration of RB1 and TP53 ［J］. Endocr Pathol , 2024 , 35 ( 4 ): 325 - 337 .

VARGHESE D G , DEL RIVERO J , BERGSLAND E . Grade progression and intrapatient tumor heterogeneity as potential contributors to resistance in gastroenteropancreatic neuroendocrine tumors ［J］. Cancers , 2023 , 15 ( 14 ): 3712 .

KOZAK M , WATERS K M , LARSON B K , et al . Pancreatic well-differentiated neuroendocrine tumors are frequently undergraded on endoscopic ultrasound-guided fine needle biopsy sampling: a single institutional experience ［J］. Int J Surg Pathol , 2025 , 33 ( 5 ): 1116 - 1120 .

WANG L Q , ZHAO X T , ZHU W X , et al . Development and validation of a CT-based nomogram to preoperative prediction of pancreatic neuroendocrine tumors (pNETs) grade ［J］. Abdom Radiol , 2025 , 50 ( 11 ): 5242 - 5252 .

SHEN X D , YANG F , JIANG T Y , et al . A nomogram to preoperatively predict the aggressiveness of non-functional pancreatic neuroendocrine tumors based on CT features ［J］. Eur J Radiol , 2024 , 171 : 111284 .

YANO M , SHETTY A S , WILLIAMS G A , et al . Qualitative imaging features of pancreatic neuroendocrine neoplasms predict histopathologic characteristics including tumor grade and patient outcome ［J］. Abdom Radiol , 2022 , 47 ( 12 ): 3971 - 3985 .

BESA C , WARD S , CUI Y , et al . Neuroendocrine liver metastases: value of apparent diffusion coefficient and enhancement ratios for characterization of histopathologic grade ［J］. J Magn Reson Imaging , 2016 , 44 ( 6 ): 1432 - 1441 .

WANG L X , LIU K , LIN G W , et al . Primary hepatic neuroendocrine tumors: comparing CT and MRI features with pathology ［J］. Cancer Imaging , 2015 , 15 ( 1 ): 13 .

BELEÙ A , RIZZO G , DE ROBERTIS R , et al . Liver tumor burden in pancreatic neuroendocrine tumors: CT features and texture analysis in the prediction of tumor grade and 18 F-FDG uptake ［J］. Cancers , 2020 , 12 ( 6 ): 1486 .

HORIGUCHI S , KATO H , SHIRAHA H , et al . Dynamic computed tomography is useful for prediction of pathological grade in pancreatic neuroendocrine neoplasm ［J］. J Gastroenterol Hepatol , 2017 , 32 ( 4 ): 925 - 931 .

HYODO R , SUZUKI K , OGAWA H , et al . Pancreatic neuroendocrine tumors containing areas of iso- or hypoattenuation in dynamic contrast-enhanced computed tomography: spectrum of imaging findings and pathological grading ［J］. Eur J Radiol , 2015 , 84 ( 11 ): 2103 - 2109 .

TOSHIMA F , INOUE D , KOMORI T , et al . Is the combination of MR and CT findings useful in determining the tumor grade of pancreatic neuroendocrine tumors? ［J］. Jpn J Radiol , 2017 , 35 ( 5 ): 242 - 253 .

WANG F Q , WANG J J , LI Y , et al . Correlation of four-phase CT findings of rectal neuroendocrine neoplasms with different World Health Organization grades ［J］. Abdom Radiol , 2023 , 48 ( 3 ): 855 - 864 .

XU W B , YAN H , XU L L , et al . Correlation between radiologic features on contrast-enhanced CT and pathological tumor grades in pancreatic neuroendocrine neoplasms ［J］. J Biomed Res , 2020 , 35 ( 3 ): 179 - 188 .

CHOI T W , KIM J H , YU M H , et al . Pancreatic neuroendocrine tumor: prediction of the tumor grade using CT findings and computerized texture analysis ［J］. Acta Radiol , 2018 , 59 ( 4 ): 383 - 392 .

PAIELLA S , MARCHEGIANI G , MIOTTO M , et al . Are cystic pancreatic neuroendocrine tumors an indolent entity results from a single-center surgical series ［J］. Neuroendocrinology , 2018 , 106 ( 3 ): 234 - 241 .

KHALIL A , EWALD J , MARCHESE U , et al . A single-center experience with pancreatic cystic neuroendocrine tumors ［J］. World J Surg Oncol , 2020 , 18 ( 1 ): 208 .

REN S J , WANG X , KE N W , et al . Clinicopathological features and long-term prognosis of purely cystic pancreatic neuroendocrine tumors: a single-center experience ［J］. Asian J Surg , 2023 , 46 ( 2 ): 774 - 779 .

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