Biochemical Testing for Neuroendocrine Tumors

Vinik, Aaron I.; Silva, María P.

doi:10.1007/978-1-4419-1069-1_26

Cited by 23 publications

(60 citation statements)

References 55 publications

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“…The clinical presentation of gastroenteropancreatic neuroendocrine tumours (GEP-NETs) varies according to the site and size of the primary tumour, the presence or absence of metastatic spread, whether associated features compatible with a hereditary syndrome exist or not, whether the tumour is functional or not and, if so, what syndrome is present (Rindi et al 2000, Metz & Jensen 2008, Vinik et al 2009). Early on in the disease process, patients present with vague symptoms associated with various hormonal symptoms that often are misdiagnosed for many years.…”

Section: Introductionmentioning

confidence: 99%

“…Early on in the disease process, patients present with vague symptoms associated with various hormonal symptoms that often are misdiagnosed for many years. In such a situation, early diagnosis depends on syndromic recognition by physicians and it is achieved by appropriate laboratory testing followed later by imaging studies and a tissue diagnosis (Metz & Jensen 2008, Vinik et al 2009. A common exception to this rule occurs with midgut carcinoid syndrome-producing tumours which often present symptoms late in the disease course.…”

Section: Introductionmentioning

confidence: 99%

“…A common exception to this rule occurs with midgut carcinoid syndrome-producing tumours which often present symptoms late in the disease course. Nonfunctional tumours also commonly present late in the disease course with imageable metastases identified per chance or when studies are ordered for symptoms attributable to tumour growth rather than hormone production (Metz & Jensen 2008, Vinik et al 2009). …”

Section: Introductionmentioning

confidence: 99%

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Circulating biomarkers in gastroenteropancreatic neuroendocrine tumours

Öberg

2011

Endocrine-Related Cancer

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Circulating biomarkers in gastroenteropancreatic neuroendocrine tumours

Öberg

2011

Endocrine-Related Cancer

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“…Several studies report on the utility of tumor markers, such as chromogranin A (CgA) and neuron specific enolase (NSE) in the setting of pNETs [21][22][23]. It is worth noting that CgA is hindered by a moderate specificity (sensitivity: 72-100 %; specificity: 50-80 %), and NSE has been reported to have a poor sensitivity (sensitivity: 30-40 %; specificity: ∼100 %) limiting their utility as reliable diagnostic tools.…”

Section: Diagnosismentioning

confidence: 99%

“…It is worth noting that CgA is hindered by a moderate specificity (sensitivity: 72-100 %; specificity: 50-80 %), and NSE has been reported to have a poor sensitivity (sensitivity: 30-40 %; specificity: ∼100 %) limiting their utility as reliable diagnostic tools. Nevertheless, characteristic of serum CgA levels is their direct correlation with tumor burden and metastatic disease; therefore, CgA levels are often used to evaluate progression or response to therapy [21,22,24].…”

Section: Diagnosismentioning

confidence: 99%

Pancreatic Neuroendocrine Tumors: an Update

2015

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Pancreatic neuroendocrine tumors (pNETs) are rare and comprise only 1-2 % of all pancreatic neoplastic disease. Although the majority of these tumors are sporadic (90 %), pNETs can arise in the setting of several different hereditary genetic syndromes, most commonly multiple endocrine neoplasia type 1 (MEN1). The presentation of pNETs varies widely, with over 60 % having malignant distant disease at the time of initial diagnosis involving the liver or other distant sites. Functioning pNETs represent approximately 10 % of all pNETs, secrete a variety of peptide hormones, and are responsible for several clinical syndromes caused by profound hormonal derangement. Surgery remains the cornerstone of therapy and the only curative approach. It should be pursued for localized disease and for metastatic lesions amenable to resection. Multimodality therapies, including liver-directed therapies and medical therapy, are gaining increasing favor in the treatment of advanced pNETs. Their utility is multifold and spans from ameliorating symptoms of hormonal excess (functional pNETs) to controlling the local and systemic disease burden (non-functional pNETs). The recent introduction of target molecular therapy has promising results especially for the treatment of progressive well-differentiated G1/G2 tumor. In this review, we summarize the current knowledge and give an update on recent advancements made in the therapeutic strategies for pNETs.

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Fully‐automated detection of small bowel carcinoid tumors in CT scans using deep learning

et al. 2023

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BackgroundSmall bowel carcinoid tumor is a rare neoplasm and increasing in incidence. Patients with small bowel carcinoid tumors often experience long delays in diagnosis due to the vague symptoms, slow growth of tumors, and lack of clinician awareness. Computed tomography (CT) is the most common imaging study for diagnosis of small bowel carcinoid tumor. It is often used with positron emission tomography (PET) to capture anatomical and functional aspects of carcinoid tumors and thus to increase the sensitivity.PurposeWe compared three different kinds of methods for the automatic detection of small bowel carcinoid tumors on CT scans, which is the first to the best of our knowledge.MethodsThirty‐three preoperative CT scans of 33 unique patients with surgically‐proven carcinoid tumors within the small bowel were collected. Ground‐truth segmentation of tumors was drawn on CT scans by referring to available 18F‐DOPA PET scans and the corresponding radiology report. These scans were split into the trainval set (n = 24) and the test positive set (n= 9). Additionally, 22 CT scans of 22 unique patients who had no evidence of the tumor were collected to comprise the test negative set. We compared three different kinds of detection methods, which are detection network, patch‐based classification, and segmentation‐based methods. We also investigated the usefulness of small bowel segmentation for reduction of false positives (FPs) for each method. Free‐response receiver operating characteristic (FROC) curves and receiver operating characteristic (ROC) curves were used for lesion‐ and patient‐level evaluations, respectively. Statistical analyses comparing the FROC and ROC curves were also performed.ResultsThe detection network method performed the best among the compared methods. For lesion‐level detection, the detection network method, without the small bowel segmentation‐based filtering, achieved sensitivity values of (60.8%, 81.1%, 82.4%, 86.5%) at per‐scan FP rates of (1, 2, 4 ,8), respectively. The use of the small bowel segmentation did not improve the performance (). For patient‐level detection, again the detection network method, but with the small bowel segmentation‐based filtering, achieved the highest AUC of 0.86 with a sensitivity of 78% and specificity of 82% at the Youden point.ConclusionsThe carcinoid tumors in this patient population were very small and potentially difficult to diagnose. The presented method showed reasonable sensitivity at small numbers of FPs for lesion‐level detection. It also achieved a promising AUC for patient‐level detection. The method may have clinical application in patients with this rare and difficult to detect disease.

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Biochemical Testing for Neuroendocrine Tumors

Cited by 23 publications

References 55 publications

Circulating biomarkers in gastroenteropancreatic neuroendocrine tumours

Circulating biomarkers in gastroenteropancreatic neuroendocrine tumours

Pancreatic Neuroendocrine Tumors: an Update

Fully‐automated detection of small bowel carcinoid tumors in CT scans using deep learning

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