Imaging of Pancreatic-Neuroendocrine Tumours: An Outline of Conventional Radiological Techniques

Abstract

IIntroduction: Pancreatic Neuroendocrine Tumours (p-NETs) are an important disease entity and comprise of peptide-secreting tumours often with a functional syndrome. : Accounting for a small percentage of all pancreatic tumours, they have a good overall survival rate when diagnosed early, with surgery being curative. The role of nuclear medicine in the diagnosis and treatment of these tumours is evident. However, the vast majority of patients will require extensive imaging in the form of conventional radiological techniques. It is important for clinicians to have a fundamental understanding of the p-NET appearances to aid prompt identification and to help direct management through neoplastic staging. Methods: This article will review the advantages and disadvantages of conventional radiological techniques in the context of p-NETs and highlight features that these tumours exhibit. Conclusion: Pancreatic neuroendocrine tumours are a unique collection of neoplasms that have markedly disparate clinical features but similar imaging characteristics. Most p-NETs are small and welldefined with homogenous enhancement following contrast administration, although larger and less welldifferentiated tumours can demonstrate areas of necrosis and cystic architecture with heterogeneous enhancement characteristics. : Prognosis is generally favourable for these tumours with various treatment options available. However, conventional radiological techniques will remain the foundation for the initial diagnosis and staging of these tumours, and a grasp of these modalities is extremely important for physicians.

Update on Epidemiology, Diagnosis, and Biomarkers in Gastroenteropancreatic Neuroendocrine Neoplasms

“…The sensitivity is 73% for tumors with suspected primary tumors, 95% for unknown primary tumors, 80% for liver metastases, and 75% for extrahepatic metastases. The threshold of detection is 0.5 cm [ 42 ]. Morphological imaging may fail to detect small tumors, especially those located in the stomach, duodenum, and small intestine [ 34 ].…”

Molecular Imaging and Theranostics in Pancreatic Neuroendocrine Tumours: From a Luminous Present to an Even Brighter Future

“…The radiological aspects regarding the theranostic of PanNETs should not be underestimated neither be allocated on a second level in comparison to molecular imaging. For this reason, this issue also includes an outline on the available conventional radiological techniques that are currently used in PanNETs work-up [5]. In the presence of a primary role of nuclear medicine, either for a whole body analysis or for a molecular characterization, an extensive conventional radiological imaging is however requested, remaining the foundation for the initial diagnosis and staging of these tumors.…”

The role of somatostatin receptor scintigraphy in the diagnosis and follow-up of the pancreatic neuroendocrine neoplasms

“…Pan cre atic neuroendocrine neoplasms (PanNEN) are a het er o ge neous group of tu mors with dif fer ent clin ical but sim i lar im ag ing pos si bil i ties and char ac ter is tics. If they are di ag nosed early, in gen eral, their over all survival is good [3]. Cu ra tive sur gery is the best treat ment but many pa tients may have small le sions that are dif ficult to de tect, or wide spread dis ease by the time of di agno sis.…”