Computed Tomography and Magnetic Resonance Imaging in the Diagnosis of Primary Neuroendocrine Tumors of the Liver

Abstract

We selected 992 patients who presented to our hospital for treatment and were diagnosed with a neuroendocrine tumor (NET) between January 1, 2008, and December 31, 2018, of whom 17 were diagnosed with primary hepatic neuroendocrine neoplasm. The clinical data were analyzed to study the clinical value of computed tomography (CT) and magnetic resonance imaging data in the diagnosis of the disease. Nine tumors (52.9%) were in the right lobe of the liver, and 9 tumors (52.9%) were single. On imaging, the arterial phase, venous phase, and delayed phase continued to be slightly enhanced, showing low-density change relative to the liver and no portal tumor thrombus formation. Four patients (23.5%) had distant metastases, including adrenal glands, portal interstitial lymph nodes, retroperitoneal lymph nodes, and the gallbladder and peritoneum. In terms of pathological grade, there were 3 cases of NET G2, 2 cases of NET G3, 10 cases of neuroendocrine carcinoma (NEC; including 2 cases of large-cell NEC and 3 cases of small-cell NEC), and 2 cases of hepatocellular carcinoma and small-cell NEC. Seven patients were treated with surgery alone, 4 patients were treated with transcatheter arterial chemoembolization (TACE), and 2 patients were treated with other therapies. Three patients were not treated with surgery and were treated with TACE, etoposide and cisplatin, and octreotide acetate. One patient was discharged automatically. The tumor density on CT images was lower than that of the liver parenchyma; medium-high enhancement was seen in the arterial enhancement phase, and continuous enhancement was seen in the venous phase, but the degree of enhancement was reduced, and rarely with portal tumor thrombosis. Currently, surgery is the main treatment method; however, postoperative combined TACE is superior to surgery in combination with microwave ablation, chemotherapy, and other treatments.

Keywords: Computed tomography; Diagnosis; Magnetic resonance imaging; Neuroendocrine tumor; Primary hepatic neuroendocrine neoplasm.