Growth Kinetics of Pancreatic Neuroendocrine Neoplasms by Histopathologic Grade

The aims of the study are to describe the growth kinetics of pathologically proven, treatment-naive pancreatic neuroendocrine neoplasms (panNENs) at imaging surveillance and to determine their association with histopathologic grade and Ki-67.

This study included 100 panNENs from 95 patients who received pancreas protocol computed tomography or magnetic resonance imaging from January 2005 to July 2022. All masses were treatment-naive, had histopathologic correlation, and were imaged with at least 2 computed tomography or magnetic resonance imaging at least 90 days apart. Growth kinetics was assessed using linear and specific growth rate, stratified by grade and Ki-67. Masses were also assessed qualitatively to determine other possible imaging predictors of grade.

There were 76 grade 1 masses, 17 grade 2 masses, and 7 grade 3 masses. Median (interquartile range) linear growth rates were 0.06 cm/y (0-0.20), 0.40 cm/y (0.22-1.06), and 2.70 cm/y (0.41-3.89) for grade 1, 2, and 3 masses, respectively ( P < 0.001). Linear growth rate correlated with Ki-67 with r2 of 0.623 ( P < 0.001). At multivariate analyses, linear growth rate was the only imaging feature significantly associated with grade ( P = 0.009).

Growth kinetics correlate with Ki-67 and grade. Grade 1 panNENs grow slowly versus grade 2-3 panNENs.