Computer-assisted and magnetic resonance imaging assessment of tumors and tumor invasion of the duodenum

Aim: To present the computed tomography and magnetic resonance imaging assessments of benign and malignant duodenal tumors, pancreatic head adenocarcinoma invading the duodenum, and duodenal dystrophy.

Methods: We searched for scientific papers and clinical guidelines in the information and analytical databases PubMed and Google Scholar from the 2013–2021 period using the following search terms: duodenal neoplasms, adenocarcinoma, duodenum, duodenal neuroendocrine tumors, duodenal adenoma, gastrointestinal stromal tumor, cholangiocarcinoma, radiology, magnetic resonance imaging, computed tomography, pancreatic head cancer. Then, we examined the reference lists of all the identified studies to collate the papers that would meet the eligibility criteria.

Results: We analyzed 1494 articles, 22 of which were included in our review. From the papers published within 1992–2021, 35 articles from the reference lists were additionally included. Based on the search results, several domains of articles were clustered; the articles from those domains were reviewed and evaluated that involved the abovementioned diagnostic features.

Conclusion: The early diagnosis and selection of appropriate management methods remain extremely relevant for the treatment of duodenal tumors, and hence, require careful attention from diagnosticians and clinicians.

1. Pham M.D., Doan P.V., Nguyen M.T. A rare congenital anomaly of the duodenal shape incidentally found at duodenopancreatectomy: a case report and literature review. Int. J. Surg. Case Rep. 2021; 85: 106269. https://doi.org/10.1016/j.ijscr.2021.106269

2. Matsuzaki J., Suzuki H., Shimoda M., Mori H., Fukuhara S., Miyoshi S., Masaoka T., Iwao Y., Kanai Y., Kanai T. Clinical and endoscopic findings to assist the early detection of duodenal adenoma and adenocarcinoma. United European Gastroenterol. J. 2019; 7 (2): 250–260. https://doi.org/10.1177/2050640618817689

3. Barat M., Dohan A., Dautry R., Barral M., Boudiaf M., Hoeffe C., Soyer P. Mass-forming lesions of the duodenum: a pictorial review. Diagn. Interv. Imaging. 2017; 98 (10): 663–675. https://doi.org/10.1016/j.diii.2017.01.004

4. Sakae H., Kanzaki H., Nasu J., Akimoto Y., Matsueda K., Yoshioka M., Nakagawa M., Hori S., Inoue M., Inaba T., Imagawa A., Takatani M., Takenaka R., Suzuki S., Fujiwara T., Okada H. The characteristics and outcomes of small bowel adenocarcinoma: a multicentre retrospective observational study. Br. J. Cancer. 2017; 117 (11): 1607–1613. https://doi.org/10.1038/bjc.2017.338

5. Negri E., Bosetti C., La Vecchia C., Fioretti F., Conti E., Franceschi S. Risk factors for adenocarcinoma of the small intestine. Int. J. Cancer. 1999; 82 (2): 171–174. https://doi. org/10.1002/(sici)1097-0215(19990719)82:23.0.co;2-t

6. Wu A.H., Yu M.C., Mack T.M. Smoking, alcohol use, dietary factors and risk of small intestinal adenocarcinoma. Int. J. Cancer. 1997; 70 (5): 512–517. https://doi.org/10.1002/ (sici)1097-0215(19970304)70:53.0.co;2-0

7. Aparicio T., Zaanan A., Svrcek M., Laurent-Puig P., Carrere N., Manfredi S., Locher C., Afchain P. Small bowel adenocarcinoma: epidemiology, risk factors, diagnosis and treatment. Dig. Liver Dis. 2014; 46 (2): 97–104. https://doi.org/10.1016/j.dld.2013.04.013

8. McNeeley M.F., Lalwani N., Dhakshina Moorthy G., Maki J., Dighe M.K., Lehnert B., Prasad S.R. Multimodality imaging of diseases of the duodenum. Abdom. Imaging. 2014; 39 (6): 1330–1349. https://doi.org/10.1007/s00261-014-0157-2

9. Ishida H., Konno K., Sato M., Naganuma H., Komatsuda T., Yamada N., Hamashima Y., Ishida J., Segawa D., Watanabe S. Duodenal carcinoma: sonographic findings. Abdom. Imaging. 2001; 26 (5): 469–473. https://doi.org/10.1007/s002610000187

10. Kim J.H., Kim M.J., Chung J.J., Lee W.J., Yoo H.S., Lee J.T. Differential diagnosis of periampullary carcinomas at MR imaging. Radiographics. 2002; 22 (6): 1335–1352. https://doi.org/10.1148/rg.226025060

11. Kazerooni E.A., Quint L.E., Francis I.R. Duodenal neoplasms: predictive value of CT for determining malignancy and tumor resectability. AJR Am. J. Roentgenol. 1992; 159 (2): 303–309. https://doi.org/10.2214/ajr.159.2.1632344

12. Buck J.L., Elsayed A.M. Ampullary tumors: radiologicpathologic correlation. Radiographics. 1993; 13 (1): 193–212. https://doi.org/10.1148/radiographics.13.1.8426928

13. Beham A., Schaefer I.M., Cameron S., von Hammerstein K., Füzesi L., Ramadori G., Ghadimi M.B. Duodenal GIST: a single center experience. Int. J. Colorectal Dis. 2013; 28 (4): 581–590. https://doi.org/10.1007/s00384-012-1432-8

14. Cavallaro G., Polistena A., D'Ermo G., Pedullà G., De Toma G. Duodenal gastrointestinal stromal tumors: review on clinical and surgical aspects. Int. J. Surg. 2013; 10 (9): 463–465. https://doi.org/10.1016/j.ijsu.2012.08.015

15. Miettinen M., Lasota J. Gastrointestinal stromal tumors: review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch. Pathol. Lab. Med. 2006; 130 (10): 1466–1478. https://doi.org/10.5858/2006-130-1466-GSTROM

16. Du H., Ning L., Li S., Lou X., Chen H., Hu F., Shan G., Zhang F., Xu G. Diagnosis and treatment of duodenal gastrointestinal stromal tumors. Clin. Transl. Gastroenterol. 2020; 11 (3): e00156. https://doi.org/10.14309/ctg.0000000000000156

17. Jung H., Lee S.M., Kim Y.C., Byun J., Kwon M.J. A pictorial review on clinicopathologic and radiologic features of duodenal gastrointestinal stromal tumors. Diagn. Interv. Radiol. 2020; 26 (4): 277–283. https://doi.org/10.5152/dir.2019.19432

18. Ren S., Chen X., Wang J., Zhao R., Song L., Li H., Wang Z. Differentiation of duodenal gastrointestinal stromal tumors from hypervascular pancreatic neuroendocrine tumors in the pancreatic head using contrast-enhanced computed tomography. Abdom. Radiol. (NY). 2019; 44 (3): 867–876. https://doi.org/10.1007/s00261-018-1803-x

19. Clift A.K., Kidd M., Bodei L., Toumpanakis C., Baum R.P., Oberg K., Modlin I.M., Frilling A. Neuroendocrine neoplasms of the small bowel and pancreas. Neuroendocrinology. 2020; 110 (6): 444–476. https://doi.org/10.1159/000503721

20. Sato Y., Hashimoto S., Mizuno K., Takeuchi M., Terai S. Management of gastric and duodenal neuroendocrine tumors. World J. Gastroenterol. 2016; 22 (30): 6817–6828. https://doi.org/10.3748/wjg.v22.i30.6817

21. Howe J.R., Cardona K., Fraker D.L., Kebebew E., Untch B.R., Wang Y.Z., Law C.H., Liu E.H., Kim M.K., Menda Y., Morse B.G., Bergsland E.K., Strosberg J.R., Nakakura E.K., Pommier R.F. The surgical management of small bowel neuroendocrine tumors: consensus guidelines of the North American Neuroendocrine Tumor Society. Pancreas. 2017; 46 (6): 715–731. https://doi.org/10.1097/MPA.0000000000000846

22. Tsai S.D., Kawamoto S., Wolfgang C.L., Hruban R.H., Fishman E.K. Duodenal neuroendocrine tumors: retrospective evaluation of CT imaging features and pattern of metastatic disease on dual-phase MDCT with pathologic correlation. Abdom. Imaging. 2015; 40 (5): 1121–1130. https://doi.org/10.1007/s00261-014-0322-7

23. Nagtegaal I.D., Odze R.D., Klimstra D., Paradis V., Rugge M., Schirmacher P., Washington K.M., Carneiro F., Cree I.A. WHO Classification of Tumours Editorial Board The 2019 WHO classification of tumours of the digestive system. Histopathology. 2020; 76 (2): 182–188. https://doi.org/10.1111/his.13975

24. Yang M., Zeng L., Ke N.W., Tan C.L., Tian B.L., Liu X.B., Xiang B., Zhang Y. World Health Organization grading classification for pancreatic neuroendocrine neoplasms: a comprehensive analysis from a large Chinese institution. BMC Cancer. 2020; 20 (1): 906. https://doi.org/10.1186/s12885-020-07356-5

25. Reznek R.H. CT/MRI of neuroendocrine tumours. Cancer Imaging. 2006; 6 (Spec No A): S163–S177. https://doi.org/10.1102/1470-7330.2006.9037

26. Kanzaki H., Matsueda K., Nakagawa M., Inaba T., Takatani M., Takenaka R., Yoshioka M., Imagawa A., Inoue M., Suzuki S., Tomoda J., Iwamuro M., Kawano S., Kawahara Y., Tanaka T., Okada H. Clinical characteristics and course of sporadic nonampullary duodenal adenomas: a multicenter retrospective study. Medicine (Baltimore). 2021; 100 (39): e27382. https://doi.org/10.1097/MD.0000000000027382

27. Collaborative Group on Duodenal Polyposis in MAP, Thomas L.E., Hurley J.J., Sanchez A.A., Aznárez M.R., Backman A.S., Bjork J., Capella G., Clark S.K., Colas C., Dekker E., Dolwani S., Ghorbanoghli Z., Gonn M., Gonzalez Romero S., Hes F.J., Jundi H., Kelland S., Latchford A.R., Brito H.L., Sampson J.R. Duodenal adenomas and cancer in MUTYH-associated polyposis: an international cohort study. Gastroenterology. 2021; 160 (3): 952–954.e4. https://doi.org/10.1053/j.gastro.2020.10.038

28. Na H.K., Kim D.H., Ahn J.Y., Lee J.H., Jung K.W., Choi K.D., Song H.J., Lee G.H., Jung H.Y. Clinical outcomes following endoscopic treatment for sporadic nonampullary duodenal adenoma. Dig. Dis. 2020; 38 (5): 364–372. https://doi.org/10.1159/000504249

29. Ma M.X., Bourke M.J. Management of duodenal polyps. Best Pract. Res. Clin. Gastroenterol. 2017; 31 (4): 389–399. https://doi.org/10.1016/j.bpg.2017.04.015

30. Pavlovic-Markovic A., Dragasevic S., Krstic M., Stojkovic Lalosevic M., Milosavljevic T. Assessment of duodenal adenomas and strategies for curative therapy. Dig. Dis. 2019; 37 (5): 374–380. https://doi.org/10.1159/000496697

31. Okada K., Fujisaki J., Kasuga A., Omae M., Kubota M., Hirasawa T., Ishiyama A., Inamori M., Chino A., Yamamoto Y., Tsuchida T., Nakajima A., Hoshino E., Igarashi M. Sporadic nonampullary duodenal adenoma in the natural history of duodenal cancer: a study of follow-up surveillance. Am. J. Gastroenterol. 2011; 106 (2): 357–364. https://doi.org/10.1038/ajg.2010.422

32. Heidecke C.D., Rosenberg R., Bauer M., Werner M., Weigert N., Ulm K., Roder J.D., Siewert J.R. Impact of grade of dysplasia in villous adenomas of Vater's papilla. World J. Surg. 2002; 26 (6): 709–714. https://doi.org/10.1007/s00268-002-6215-x

33. Eng N.L., Mustin D.E., Lovasik B.P., Turgeon M.K., Gamboa A.C., Shah M.M., Cardona K., Sarmiento J.M., Russell M.C., Maithel S.K., Switchenko J.M., Kooby D.A. Relationship between cancer diagnosis and complications following pancreatoduodenectomy for duodenal adenoma. Ann. Surg. Oncol. 2021; 28 (2): 1097–1105. https://doi.org/10.1245/s10434-020-08767

34. Alessandrino F., Ivanovic A.M., Yee E.U., Radulovic D., Souza D., Mortele K.J. MDCT and MRI of the ampulla of Vater. Part I: technique optimization, normal anatomy, and epithelial neoplasms. Abdom. Imaging. 2015; 40 (8): 3274–3291. https://doi.org/10.1007/s00261-015-0528-3

35. Lee M., Kim M.J., Park M.S., Choi J.Y., Chung Y.E. Using multi-detector-row CT to diagnose ampullary adenoma or adenocarcinoma in situ. Eur. J. Radiol. 2011; 80 (3): e340–345. https://doi.org/10.1016/j.ejrad.2010.10.022

36. Fernandes D.A., Boteon Y.L., Boteon A., Sousa R., Martins D.L., Penachim T.J., Barros R., Martins R., Costa L., Cazzo E., Gestic M.A., Chaim E.A., Caserta N. Tubulovillous adenoma of the duodenal papilla: radiological-endoscopic and anatomopathological correlation in the surgical proposal. Rev. Assoc. Med. Bras. (1992). 2020; 66 (9): 1190–1195. https://doi.org/10.1590/1806-9282.66.9.1190

37. Hwang J.I., Chiang J.H., Yu C., Cheng H.C., Chang C.Y., Mueller P.R. Pictorial review: radiological diagnosis of duodenal abnormalities. Clin. Radiol. 1998; 53 (5): 323–332. https://doi.org/10.1016/s0009-9260(98)80002-0

38. Wang K.P., Jiang H., Kong C., Wang L.Z., Wang G.Y., Mo J.G., Jin C. Adult duodenal intussusception with horizontal adenoma: a rare case report. World J. Clin. Cases. 2020; 8 (15): 3314–3319. https://doi.org/10.12998/wjcc.v8.i15.3314

39. Tawarungruang C., Khuntikeo N., Chamadol N., Laopaiboon V., Thuanman J., Thinkhamrop K., Kelly M., Thinkhamrop B. Survival after surgery among patients with cholangiocarcinoma in Northeast Thailand according to anatomical and morphological classification. BMC Cancer. 2021; 21 (1): 497. https://doi.org/10.1186/s12885-021-08247-z

40. Yao K.J., Jabbour S., Parekh N., Lin Y., Moss R.A. Increasing mortality in the United States from cholangiocarcinoma: an analysis of the National Center for Health Statistics Database. BMC Gastroenterol. 2016; 16 (1): 117. https://doi.org/10.1186/s12876-016-0527-z

41. Zhao D.Z., Guo Y., Sun Y.P., Liu H.M., Zhang Z., Ma Q.L., Wang Y.S., Chen C.L. Multi-detector spiral CT diagnosis of common bile duct ampullary carcinoma. Eur. Rev. Med. Pharmacol. Sci. 2017; 21 (16): 3549–3553.

42. Maki T., Irisawa A., Notohara K., Shibukawa G., Sato A., Yamabe A., Yoshida Y., Yamamoto S., Soeta N., Saito T. Duodenal stenosis due to carcinoma of the lower bile duct: a case report. Clin. Med. Insights Case Rep. 2020; 13: 1179547620919453. https://doi.org/10.1177/1179547620919453

43. Hennedige T.P., Neo W.T., Venkatesh S.K. Imaging of malignancies of the biliary tract – an update. Cancer Imaging. 2014; 14 (1): 14. https://doi.org/10.1186/1470-7330-14-14

44. Ito K., Ito H., Allen P.J., Gonen M., Klimstra D., D'Angelica M.I., Fong Y., DeMatteo R.P., Brennan M.F., Blumgart L.H., Jarnagin W.R. Adequate lymph node assessment for extrahepatic bile duct adenocarcinoma. Ann. Surg. 2010; 251 (4): 675–681. https://doi.org/10.1097/SLA.0b013e3181d3d2b2

45. Ebata T., Nagino M., Nishio H., Igami T., Yokoyama Y., Nimura Y. Pancreatic and duodenal invasion in distal bile duct cancer: paradox in the tumor classification of the American Joint Committee on Cancer. World J. Surg. 2007; 31 (10): 2008–2015. https://doi.org/10.1007/s00268-007-9173-5

46. Buckholz A.P., Brown R.S. Jr. Cholangiocarcinoma: diagnosis and management. Clin. Liver Dis. 2020; 24 (3): 421–436. https://doi.org/10.1016/j.cld.2020.04.005

47. D'Antuono F., De Luca S., Mainenti P.P., Mollica C., Camera L., Galizia G., Brunetti A., Maurea S. Comparison between multidetector CT and high-field 3T MR imaging in diagnostic and tumour extension evaluation of patients with cholangio carcinoma. J. Gastrointest. Cancer. 2020; 51 (2): 534– 544. https://doi.org/10.1007/s12029-019-00276-z

48. Kim S.Y. Preoperative radiologic evaluation of cholangiocarcinoma. Korean J. Gastroenterol. 2017; 69 (3): 159–163. https://doi.org/10.4166/kjg.2017.69.3.159

49. Siripongsakun S., Sapthanakorn W., Mekraksakit P., Vichitpunt S., Chonyuen S., Seetasarn J., Bhumiwat S., Sricharunrat T., Srittanapong S. Premalignant lesions of cholangio carcinoma: characteristics on ultrasonography and MRI. Abdom. Radiol. (NY). 2019; 44 (6): 2133–2146. https://doi.org/10.1007/s00261-019-01951-2

50. Zhu H., Li T., Du Y., Li M. Pancreatic cancer: challenges and opportunities. BMC Med. 2018; 16 (1): 214. https://doi.org/10.1186/s12916-018-1215-3

51. Chang S.T., Jeffrey R.B., Patel B.N., DiMaio M.A., Rosenberg J., Willmann J.K., Olcott E.W. Preoperative multidetector CT diagnosis of extrapancreatic perineural or duodenal invasion is associated with reduced postoperative survival after pancreaticoduodenectomy for pancreatic adenocarcinoma: preliminary experience and implications for patient care. Radiology. 2016; 281 (3): 816–825. https://doi.org/10.1148/radiol.2016152790

52. Rhee H., Park M.S. The role of imaging in current treatment strategies for pancreatic adenocarcinoma. Korean J. Radiol. 2021; 22 (1): 23–40. https://doi.org/10.3348/kjr.2019.0862

53. Chen F.M., Ni J.M., Zhang Z.Y., Zhang L., Li B., Jiang C.J. Presurgical evaluation of pancreatic cancer: a comprehensive imaging comparison of CT versus MRI. AJR Am. J. Roentgenol. 2016; 206 (3): 526–535. https://doi.org/10.2214/AJR.15.15236

54. Chu L.C., Goggins M.G., Fishman E.K. Diagnosis and detection of pancreatic cancer. Cancer J. 2017; 23 (6): 333–342. https://doi.org/10.1097/PPO.0000000000000290

55. Campos L.P., Mateu C.A., García-Argüelles J.S., Durá Ayet A.B., Pérez I.B., Callol P.S. Cystic dystrophy of the duodenal wall: a rare but need-to-know disease. Endosc. Ultrasound. 2017; 6 (1): 61–66. https://doi.org/10.4103/2303-9027.200207

56. Tison C., Regenet N., Meurette G., Mirallié E., Cassagnau E., Frampas E., Le Borgne J. Cystic dystrophy of the duodenal wall developing in heterotopic pancreas: report of 9 cases. Pancreas. 2007; 34 (1): 152–156. https://doi.org/10.1097/01.mpa.0000246669.61246.08

57. Vullierme M.P., Vilgrain V., Fléjou J.F., Zin M., O'Toole D., Ruszniewski P., Belghiti J., Menu Y. Cystic dystrophy of the duodenal wall in the heterotopic pancreas: radiopathological correlations. J. Comput. Assist. Tomogr. 2000; 24 (4): 635–643. https://doi.org/10.1097/00004728-200007000-00023