ArticleWorld journal of radiology2025
Computed tomography-guided percutaneous biopsy for assessing tumor heterogeneity in neuroendocrine tumor metastases to the liver.
Article in World journal of radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGastroenteropancreatic neuroendocrine tumors (GEP-NETs) frequently metastasize to the liver, with heterogeneity in tumor grade impacting patient prognosis and treatment. The Ki-67 index, a key prognostic marker, often varies between primary and metastatic sites; however, routine liver biopsy remains controversial. Although percutaneous computed tomography-guided core needle biopsy (PCT-CNB) is safe and effective for focal lesions, its role in detecting intertumor grading discrepancies and survival implications in GEP-NETs is underexplored. Conflicting survival associations with grade shifts have been reported in previous studies. We hypothesized that PCT-CNB could identify clinically significant grading heterogeneity in liver metastases, correlating with survival outcomes, thereby refining risk stratification and therapeutic strategies.
aimTo investigate intertumor grading heterogeneity in GEP-NET liver metastases
methodsWe retrospectively investigated 92 patients with liver metastases from GEP-NETs
resultsNo procedure-related mortality was recorded during or after biopsy. In 37/92 patients (40.2%), the grading classifications changed: The grading increased from G1 to G2 in 13 patients, from G1 to G3 in 2, and from G2 to G3 in 14; the grading decreased from G2 to G1 in 5 patients, from G3 to G1 in 1, and from G3 to G2 in 2. Patients with G1 or G2 disease had better progression-free survival and overall survival (OS) outcomes than those with G3 disease did (
conclusionThe PCT-CNB of liver metastases from GEP-NETs differed in grade between the liver tumor and primary site/secondary liver metastases. Additionally, when grading increased from G2, the OS rate significantly decreased.
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