Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. May 15, 2019; 11(5): 436-448
Published online May 15, 2019. doi: 10.4251/wjgo.v11.i5.436
Analysis of B-ultrasound and contrast-enhanced ultrasound characteristics of different hepatic neuroendocrine neoplasm
Xiao-Ning Kang, Xiao-Yu Zhang, Jie Bai, Zun-Yi Wang, Wen-Jie Yin, Li Li
Xiao-Ning Kang, Li Li, Department of Second Ultrasound, Cangzhou Central Hospital, Cangzhou 061001, Hebei Province, China
Xiao-Yu Zhang, Jie Bai, Zun-Yi Wang, Department of Third Oncology, Cangzhou Central Hospital, Cangzhou 061001, Hebei Province, China
Wen-Jie Yin, Department of Gastroenterology, Cangzhou Central Hospital, Cangzhou 061001, Hebei Province, China
Author contributions: Kang XN, Zhang XY, and Li L designed the research; Kang XN, Bai J, and Wang ZY performed the research; Li L and Yin WJ contributed new reagents/analytic tools; Kang XN, Bai J, and Zhang XY analyzed the data; and Kang XN, Zhang XY, and Li L wrote the paper.
Institutional review board statement: The study was approved by the ethics committee of Cangzhou Central Hospital.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Li Li, MD, Chief Physician, Department of Second Ultrasound, Cangzhou Central Hospital, No. 16 Xinhua West Road, Yunhe District, Cangzhou 061001, Hebei Province, China. lilijobdoc@126.com
Telephone: +86-317-2075790
Received: January 30, 2019
Peer-review started: January 30, 2019
First decision: March 14, 2019
Revised: March 19, 2019
Accepted: March 26, 2019
Article in press: March 26, 2019
Published online: May 15, 2019
Processing time: 106 Days and 3.3 Hours
Research background

Hepatic neuroendocrine neoplasm (hNEN) is a rare tumor clinically. It is important to identify the source and malignant degree of hNEN and distinguish it from hepatocellular carcinoma (HCC). Imaging examination is required for the initial screening of hNEN. However, there is a lack of data regarding imaging diagnosis of hNEN.

Research motivation

Because of the lack of imaging examination experience, the screening and identification of hNEN is difficult. Research has revealed that there are some differences among hNEN with different sources and malignant degrees screened by ultrasound and contrast-enhanced ultrasound (CEUS). By analyzing the characteristics of ultrasound and CEUS, our study hopes to provide more helpful information in the diagnosis of hNEN.

Research objectives

In this study, the ultrasound performance between hNEN and HCC and data of hNEN with different sources and malignant degrees were compared. The purpose of this study was to improve the accuracy of the identification of hNEN and provide useful information for its clinical diagnosis.

Research methods

A total of 55 patients with hNEN were recruited, the hNEN group. There were 35 cases in the hepatic neuroendocrine tumor (hNET) group, and 20 cases in the neuroendocrine carcinoma (hNEC) group. About 55 patients with HCC were recruited as the HCC group. The characteristic differences of B-mode ultrasound and CEUS between hNEN and HCC, hNEN from different sources, and between hNEC and hNET were compared and analyzed.

Research results

Compared with the HCC group, the proportions of multiple liver lesions, unclear borders, and high echo lesions were higher and the proportions of non-uniform echo and peripheral acoustic halo were lower in the hNEN group. In the NEN group, the washout to iso-enhancement time and washout to hypo-enhancement time were lower than those of the HCC group. The proportion of low enhancement of portal venous phase, non-uniform enhancement forms, and combined tumor vasculature in the hNEC group was greater than that in the hNEN group.

Research conclusions

Compared with HCC, the ultrasound performance of hNEN showed more intrahepatic lesions, uniform high echo, uniform high enhancement at arterial phase, and rapid washout. Compared with hNET, the CEUS characteristics of hNEC are low enhancement of portal venous phase, non-uniform enhancement forms, and combined tumor vasculature.

Research perspectives

To expand this research, future studies should include more hospitals in order to collect detailed data from more hNEN patients. The ultrasound results of primary hNEN also need to be analyzed further to provide stronger evidence for clinical diagnosis.