ArticleAnnals of surgery2023
Grading Pancreatic Neuroendocrine Tumors Via Endoscopic Ultrasound-guided Fine Needle Aspiration: A Multi-institutional Study.
Article in Annals of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Clinical Utility of EUS-FNA/FNB for Diagnosis and Grade Assessment in Pancreatic Neuroendocrine Tumors < 20 mm: A Systematic Review and Meta-Analysis.Journal of hepato-biliary-pancreatic sciences · 2026Pooled it
- Diagnostic performance of artificial intelligence versus conventional imaging for differentiating G2/G3 from G1 pancreatic neuroendocrine tumors: a systematic review and meta-analysis.BMC medical imaging · 2026Pooled it
- ASO Author Reflections: Automated Radiomics Model for Preoperative Pancreatic Neuroendocrine Tumor Grade Prediction.Annals of surgical oncology · 2026Article
- Automated Radiomics Model for Preoperative Pancreatic Neuroendocrine Tumor Grade Prediction.Annals of surgical oncology · 2026Article
- PNET-PRISM: a multicenter-validated radiomics nomogram for noninvasive grading of pancreatic neuroendocrine tumors.Insights into imaging · 2026Article
- Association between tomoelastography and histological grade and clinical characteristics of pancreatic neuroendocrine neoplasms.Gastroenterology report · 2026Article
- Radiomics analysis of dual-energy CT-derived iodine maps for predicting histopathologic grading of pancreatic ductal adenocarcinoma: a two-center study.Frontiers in medicine · 2026Article
- Dual-energy computed tomography for predicting histological grading and survival in patients with pancreatic ductal adenocarcinoma.European radiology · 2025Article
- A CT-based interpretable machine learning model for preoperative prediction of pancreatic neuroendocrine tumor aggressiveness.Frontiers in oncology · 2025Article
- A radiomics-based interpretable model to predict the pathological grade of pancreatic neuroendocrine tumors.European radiology · 2024Article
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- Accurate non-invasive grading of nonfunctional pancreatic neuroendocrine tumors with a CT derived radiomics signature.Diagnostic and interventional imaging · 2024Article
- Response to Commentary "Are Parenchyma-Sparing Resections Really Appropriate for Small (<3 cm) Non-Functional Pancreatic Neuroendocrine Tumors?"Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2023Article
- Contrast Enhanced EUS for Predicting Solid Pancreatic Neuroendocrine Tumor Grade and Aggressiveness.Diagnostics (Basel, Switzerland) · 2023Review
- Endoscopic ultrasound-guided side-fenestrated needle biopsy sampling is sensitive for pancreatic neuroendocrine tumors but inadequate for tumor grading: a prospective study.Scientific reports · 2022Article
- Outcome of nonfunctioning pancreatic neuroendocrine tumors after initial surveillance or surgical resection: a single-center observational study.Annals of gastroenterologyArticle
- Educational Case: Pancreatic neuroendocrine neoplasms.Academic pathologyArticle
Corrections and comments
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Authors and funding
18 authors at 7 institutions in 1 country.
Funding
Abstract
objectivesTo identify factors associated with concordance between World Health Organization (WHO) grade on cytological analysis (c-grade) and histopathological analysis (h-grade) of surgical specimen in patients with PanNETs and examine trends in utilization and accuracy of EUS-FNA in preoperatively predicting grade.
backgroundWHO grading system is prognostic in pancreatic neuroendo-crine tumors (PanNETs). The concordance between c-grade and h-grade is reported to be between 50% and 92%.
methodsA multicenter retrospective study was performed on patients undergoing resection for PanNETs at four high-volume centers between 2010 and 2019. Patients with functional or syndrome-associated tumors, and those receiving neoadjuvant therapy were excluded. Factors associated with concordance between c-grade and h-grade and trends of utilization of EUS-FNA were assessed.
resultsOf 869 patients included, 517 (59.5%) underwent EUS-FNA; 452 (87.4%) were diagnostic of PanNETs and WHO-grade was reported for 270 (59.7%) patients. The concordance between c-grade and h-grade was 80.4% with moderate concordance ( Kc = 0.52, 95% CI: 0.41-0.63). Significantly higher rates of concordance were observed in patients with smaller tumors (<2 vs. ≥2cm, 81.1% vs. 60.4%, P = 0.005). Highest concordance (98.1%) was observed in patients with small tumors undergoing assessment between 2015-2019 with a near-perfect concordance ( Kc = 0.88, 95% CI: 0.61-1.00). An increase in the utilization of EUS-FNA (56.1% to 64.1%) was observed over the last 2 decades ( P = 0.017) and WHO-grade was more frequently reported (44.2% vs. 77.6%, P < 0.001). However, concordance between c-grade and h-grade did not change significantly (P = 0.118).
conclusionRecently, a trend towards increasing utilization and improved diagnostic accuracy of EUS-FNA has been observed in PanNETs. Concordance between c-grade and h-grade is associated with tumor size with near-perfect agreement when assessing PanNETs <2cm in size.
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