CT-BASED RADIOMICS AND MULTIMODAL IMAGING FOR DIFFERENTIAL DIAGNOSIS OF PANCREATIC METASTASES FROM RENAL CELL CARCINOMA

Background: Analysis of the potential of imaging methods in the differential diagnosis of renal cell carcinoma metastases to the pancreas is relevant. Materials and Methods: Sixteen patients with histologically confirmed renal cell carcinoma pancreatic metastases were treated at the A.V. Vishnevsky National Medical Research Center of Surgery from 2009 to 2025. Eleven (68.75%) patients had a history of nephrectomy within 4 to 16 years. Preoperative examination included ultrasound (n=16), MSCT with bolus contrast (n=16), MRI (n=10), and endoscopic ultrasound (n=6). Results: Solitary metastases were detected in 10 patients (62.5%). Tumors were located in the head of the pancreas in 5 patients, in the body - in 3 patients, and in the tail - in 2 patients. Multiple multifocal pancreatic lesions were in 6 patients (37.5%). The sizes of the secondary lesions ranged from 10 to 56 mm. The most informative diagnostic method for detecting focal pancreatic lesion is computed tomography with bolus contrast enhancement. Secondary tumors are most often detected subcapsularly, with an extraorgan component. The most accurate and effective texture parameters for preoperative prediction of RCC metastases were identified: CONVENTIONAL_HUmin; GLCM_Correlation; NGLDM_Coarseness; LCRA. The developed diagnostic model had a sensitivity and specificity of 95.8% and 62%, respectively, in the differential diagnosis of NETs and pancreatic renal cell carcinoma metastases, allowing its use for preoperative differential diagnosis based on MSCT scans with intravenous contrast.