Differential diagnosis of non-functional islet cell tumor and pancreatic carcinoma with sonography

ObjectiveTo investigate the differential diagnosis of non-functional islet cell tumor (NFICT) and pancreatic ductal adenocarcinoma (pancreatic carcinoma) with clinical presentation and sonographic features.Materials and methodsTwenty cases of NFICT were investigated in the study, and 41 cases of pancreatic carcinoma were included as the control group. Among them, 5 NFICT and 32 pancreatic carcinomas underwent CEUS with SonoVue. Clinical presentation and sonographic characteristics were evaluated with Logistic regression analysis. Furthermore, the preliminary result of contrast enhanced ultrasound (CEUS) was analyzed.ResultsStatistic analysis showed four significant factors in differential diagnosis for NFICT and pancreatic carcinoma, including age (P < 0.001), tumor size (P = 0.006), tumor margin (P < 0.001) and vascularity of tumor (P = 0.004). Combined these four factors, the sensitivity, specificity and accuracy are 95.0%, 95.1% and 95.1%, respectively. When the patient is younger than 60 years, and tumor is smaller than 5 cm with well-defined margin and hypervascular, it would be most likely a NFICT other than pancreatic carcinoma. NFICT often shows early enhancement and more homogeneous infusion than pancreatic carcinoma on CEUS (P = 0.005 and 0.008).ConclusionsSonography is able to provide useful differential information for NFICT, which is often misdiagnosed as pancreatic carcinoma.