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Feng N, Chen HY, Wang XJ, Lu YF, Zhou JP, Zhou QM, Wang XB, Yu JN, Yu RS, Xu JX. A CT-based nomogram established for differentiating gastrointestinal heterotopic pancreas from gastrointestinal stromal tumor: compared with a machine-learning model. BMC Med Imaging 2023; 23:131. [PMID: 37715139 PMCID: PMC10504714 DOI: 10.1186/s12880-023-01094-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/01/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE To identify CT features and establish a nomogram, compared with a machine learning-based model for distinguishing gastrointestinal heterotopic pancreas (HP) from gastrointestinal stromal tumor (GIST). MATERIALS AND METHODS This retrospective study included 148 patients with pathologically confirmed HP (n = 48) and GIST (n = 100) in the stomach or small intestine that were less than 3 cm in size. Clinical information and CT characteristics were collected. A nomogram on account of lasso regression and multivariate logistic regression, and a RandomForest (RF) model based on significant variables in univariate analyses were established. Receiver operating characteristic (ROC) curve, mean area under the curve (AUC), calibration curve and decision curve analysis (DCA) were carried out to evaluate and compare the diagnostic ability of models. RESULTS The nomogram identified five CT features as independent predictors of HP diagnosis: age, location, LD/SD ratio, duct-like structure, and HU lesion/pancreas A. Five features were included in RF model and ranked according to their relevance to the differential diagnosis: LD/SD ratio, HU lesion/pancreas A, location, peritumoral hypodensity line and age. The nomogram and RF model yielded AUC of 0.951 (95% CI: 0.842-0.993) and 0.894 (95% CI: 0.766-0.966), respectively. The DeLong test found no statistically significant difference in diagnostic performance (p > 0.05), but DCA revealed that the nomogram surpassed the RF model in clinical usefulness. CONCLUSION Two diagnostic prediction models based on a nomogram as well as RF method were reliable and easy-to-use for distinguishing between HP and GIST, which might also assist treatment planning.
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Affiliation(s)
- Na Feng
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88#, 310009, Hangzhou, China
| | - Hai-Yan Chen
- Department of Radiology, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, 310022, Hangzhou, Zhejiang, China
| | - Xiao-Jie Wang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88#, 310009, Hangzhou, China
| | - Yuan-Fei Lu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88#, 310009, Hangzhou, China
| | - Jia-Ping Zhou
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88#, 310009, Hangzhou, China
| | - Qiao-Mei Zhou
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88#, 310009, Hangzhou, China
| | - Xin-Bin Wang
- Department of Radiology, The First People's Hospital of Xiaoshan District, Hangzhou, China
| | - Jie-Ni Yu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88#, 310009, Hangzhou, China
| | - Ri-Sheng Yu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88#, 310009, Hangzhou, China.
| | - Jian-Xia Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang Chinese Medical University, Chaowang Road 318#, 310005, Hangzhou, China.
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A Case of Heterotopic Pancreatic Tissue Discovered in the Distal Esophagus. Case Rep Gastrointest Med 2020; 2020:4695184. [PMID: 32328316 PMCID: PMC7171671 DOI: 10.1155/2020/4695184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 08/28/2019] [Accepted: 03/18/2020] [Indexed: 11/17/2022] Open
Abstract
Heterotopic pancreas (HP) is a congenital abnormality that represents ectopic pancreatic tissue that does not have anatomic, vascular, or ductal continuity. The prevalence of HP is 0.55% to 13.7% on autopsy, 0.2% to 0.5% of abdominal operations, and 0.9% of gastrectomies. It is commonly found in the stomach, duodenum, and proximal jejunum. Only 15 cases have been reported in the medical literature regarding involvement of the esophagus. Treatment depends on symptoms and location. In asymptomatic patients, simple observation may be sufficient; however, in those who are symptomatic, surgery may be warranted. We present a case of a 70-year-old male with heartburn, nausea, and abdominal bloating who underwent a diagnostic esophagogastroduodenoscopy (EGD) and was found to have HP on histology in the distal esophagus. In our case, symptoms were treated conservatively and successfully with a proton pump inhibitor (PPI).
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Ruan M, Liu M, Cheng L, Xie W, Chen L. Increased 18F-FDG uptake of heterotopic pancreatitis in the small intestine: A CARE-compliant case report. Medicine (Baltimore) 2016; 95:e4465. [PMID: 27603341 PMCID: PMC5023863 DOI: 10.1097/md.0000000000004465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUD Heterotopic pancreas (HP), a relatively uncommon congenital anomaly, is rarely noted during F-FDG positron-emission tomography/computed tomography (PET/CT) scan. METHODS A 60-year-old woman was referred to our hospital due to a 10-day history of abdominal pain with elevated levels of serum amylase and lipase. Abdominal CT and ultrasound examinations were negative. In order to search for the cause, an F-FDG PET/CT whole body scan was suggested to an old woman revealing the presence of F-FDG accumulating nodule in small intestine. RESULTS Surgical findings and pathologic results confirmed the diagnosis of small intestinal heterotopic pancreas with active chronic inflammation. CONCLUSION This uncommon case underscores the necessity of considering heterotopic pancreatitis in small intestine with focal F-FDG uptake as a possible differential diagnosis in intestinal tumor and tuberculosis.
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Affiliation(s)
- Maomei Ruan
- Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital
- Department of Nuclear Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Min Liu
- Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital
| | - Lingxiao Cheng
- Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital
| | - Wenhui Xie
- Department of Nuclear Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Libo Chen
- Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital
- Correspondence: Libo Chen, Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China (e-mail: ); Wenhui Xie, Department of Nuclear Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, P.R. China (e-mail: )
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