Validation of a radiomics model to predict symptoms complications from small intestinal NET mesenteric metastases – Preliminary report

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Introduction: The development of mesenteric metastases and associated mesenteric fibrosis in small intestinal neuroendocrine tumors (SI-NET) can cause significant complications and have implications in patients’ survival. CT is suboptimal for accurate assessment of the degree of fibrosis and prediction of complications. A better model is needed, therefore, in order to select patients who may benefit from a prophylactic surgical approach in the mesentery. Recently the promising role of a radiomics model was shown as a predictive tool for development of complications of mesenteric metastases/fibrosis in 68 patients.

Aim(s): The aim of this study is to validate the radiomics model with a different patient cohort from Royal Free Hospital London, NET Unit.

Materials and methods: 20 patients with SI-NET have been included in this preliminary study which will be extended by another 20 patients. 10 of them (6 male, mean age 62 yr, 4 female, 63 yr; 6 grade I, 4 grade II) were asymptomatic (Group A), whilst the other 10 patients (7 male 62.7 yr, 3 female 49.3 yr; 6 grade I, 4 grade II) had symptoms of intestinal ischaemia and/or obstruction (Group B). In group A 5-HIAA levels were elevated in 3/10 patients whereas in group B in 4/10 patients. The histopathology fibrosis score for Group B patients has been collected. The mesenteric cuff around the metastatic node has been segmented (including desmoplasia), using a semiautomated segmentation program ITK-SNAP.

Conference:

Presenting Author:

Authors: von Stempel C, Blazevic A, Starmans M, d' Afflitto M, de Herder W,

Keywords: small intestinal neuroendocrine tumor, mesenteric fibrosis, complications, radiomics,