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Abstract

Background

Solid pseudopapillary neoplasm of the pancreas (SPNs) usually showed slight enhancement in contrast-enhanced computed tomography (CE-CT), which is similar to hypovascular pancreatic neuroendocrine tumors (hypo-PNETs).

Purpose

To show the values of CT imaging features in the differentiation between hypo-PNETs and SPNs.

Material and Methods

Forty-four patients with histologically confirmed SPNs and 24 patients with hypo-PNETs who underwent preoperative dynamic CE-CT were included. Two radiologists reviewed CT imaging findings and clinical features. Multivariate logistic regression analysis was performed to identify relevant features to differentiate SPNs and hypo-PNETs. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance.

Results

SPNs usually occurred in young women compared with hypo-PNETs (mean age = 34.5 years vs. 49.08 years, P < 0.01). SPNs usually showed an oval shape, “floating cloud” sign, calcification, and lower frequencies of metastases compared with hypo-PNETs (P < 0.05 for all). The combined features (lower age, “floating cloud” sign, and calcification) showed acceptable diagnostic performance (area under the curve [AUC] = 0.865 with 100% sensitivity and 63.6% specificity) for differentiating SPNs from hypo-PNETs.

Conclusion

“Floating cloud” sign, lower age, and calcification have great potential in differentiating SPNs from hypo-PNETs.

Keywords

Solid pseudopapillary neoplasm pancreas hypovascular pancreatic neuroendocrine tumors computed tomography

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Differentiation between solid pseudopapillary neoplasm of the pancreas and hypovascular pancreatic neuroendocrine tumors by using computed tomography