Imaging of Pancreatic Neuroendocrine Neoplasms (original) (raw)

Nuclear Medicine and Radiological Imaging of Pancreatic Neuroendocrine Neoplasms: A Multidisciplinary Update

Journal of Clinical Medicine

Pancreatic neuroendocrine neoplasms (panNENs) are part of a large family of tumors arising from the neuroendocrine system. PanNENs show low–intermediate tumor grade and generally high somatostatin receptor (SSTR) expression. Therefore, panNENs benefit from functional imaging with 68Ga-somatostatin analogues (SSA) for diagnosis, staging, and treatment choice in parallel with morphological imaging. This narrative review aims to present conventional imaging techniques and new perspectives in the management of panNENs, providing the clinicians with useful insight for clinical practice. The 68Ga-SSA PET/CT is the most widely used in panNENs, not only fr diagnosis and staging purpose but also to characterize the biology of the tumor and its responsiveness to SSAs. On the contrary, the 18F-Fluordeoxiglucose (FDG) PET/CT is not employed systematically in all panNEN patients, being generally preferred in G2–G3, to predict aggressiveness and progression rate. The combination of 68Ga-SSA PET/C...

Comparison of imaging-based and pathological dimensions in pancreatic neuroendocrine tumors

World journal of gastroenterology, 2017

To establish the ability of magnetic resonance (MR) and computer tomography (CT) to predict pathologic dimensions of pancreatic neuroendocrine tumors (PanNET) in a caseload of a tertiary referral center. Patients submitted to surgery for PanNET at the Surgical Unit of the Pancreas Institute with at least 1 preoperative imaging examination (MR or CT scan) from January 2005 to December 2015 were included and data retrospectively collected. Exclusion criteria were: multifocal lesions, genetic syndromes, microadenomas or mixed tumors, metastatic disease and neoadjuvant therapy. Bland-Altman (BA) and Mountain-Plot (MP) statistics were used to compare size measured by each modality with the pathology size. Passing-Bablok (PB) regression analysis was used to check the agreement between MR and CT. Our study population consisted of 292 patients. Seventy-nine (27.1%) were functioning PanNET. The mean biases were 0.17 ± 7.99 mm, 1 ± 8.51 mm and 0.23 ± 9 mm, 1.2 ± 9.8 mm for MR and CT, consider...

State-of-the-art Imaging of Pancreatic Neuroendocrine Tumors

Surgical oncology clinics of North America, 2016

Pancreatic neuroendocrine tumors are rare tumors that present many imaging challenges, from detecting small functional tumors to fully staging large nonfunctioning tumors, including identifying all sites of metastatic disease, particularly nodal and hepatic, and depicting vascular involvement. The correct choice of imaging modality requires knowledge of the tumor type (eg, gastrinoma versus insulinoma), and also the histology (well vs poorly differentiated). Evolving techniques in computed tomography (CT), MRI, endoscopic ultrasonography, and nuclear medicine, such as dual-energy CT, diffusion-weighted MRI, liver-specific magnetic resonance contrast agents, and new nuclear medicine agents, offer new ways to visualize, and ultimately manage, these tumors.

Pancreatic neuroendocrine tumors: the basics, the gray zone, and the target

F1000Research

Pancreatic neuroendocrine tumors (PanNETs) manifest with a range of symptoms and pose a therapeutic challenge. A team approach, in which many specialists come together, is necessary in the quest for the best patient-tailored treatment. Disciplines such as oncology, surgery, basic science, endocrinology, radiology, and nuclear medicine need to work side by side, equally contributing to patient care and to advancing our better understanding of this fascinating disease.

Advances in diagnosis and treatment of pancreatic neuroendocrine tumors

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2014

To review the current state of pancreatic neuroendocrine tumors (PNETS)Methods: The literature published between 2005 and 2014 in PUBMED, Medline, Google Scholar, Cochrane reports, and ClinicalTrials.gov was examined for relevance to the topic. PNETS have an incidence <1 per 100,000 individuals and may functionally secrete biologically active substances or be nonfunctional (NF-PNETs). PNETs occur both sporadically and in patients with various inherited disorders. Pathology and staging range from benign, well-differentiated to metastatic and dedifferentiated and are dependent on the mitotic and Ki67 indices of cell proliferation. Bone alkaline phosphatase and N-terminal telopeptide (N-telopeptide) are markers of osteoblasts and osteoclast activation, and pancreastatin, neurokinin A (NKA), chromogranin A (CgA) and neuron-specific enolase are used to determine response to therapy and prognosis. Surgical resection of the primary tumor is recommended, even when there are metastases. N...

Pancreatic neuroendocrine neoplasms: diagnosis and management

Abdominal Imaging, 2012

Pancreatic neuroendocrine neoplasms are uncommon but rising in incidence. There have been recent changes in the WHO nomenclature and a newly proposed American Joint Committee on Cancer TNM staging, which complement each other. These neoplasms are of great medical and radiological interest because of their diverse presenting features and imaging appearances. There is an increased role for both anatomic and functional imaging in the assessment of these neoplasms. A review of the nomenclature, staging, and imaging is presented in this paper.

Pancreatic neuroendocrine neoplasms - management guidelines (recommended by the Polish Network of Neuroendocrine Tumours)

Endokrynologia Polska, 2013

We present revised diagnostic and therapeutic guidelines for the management of pancreatic neuroendocrine neoplasms (PNENs) proposed by the Polish Network of Neuroendocrine Tumours.These guidelines refer to biochemical (determination of specific and nonspecific neuroendocrine markers) and imaging diagnostics (EUS, CT, MR, and radioisotope examination with a 68Ga or 99Tc labelled somatostatin analogue).A histopathological diagnostic, which determines the further management of patients with PNENs, must be necessarily confirmed by immunohistochemical tests. PNENs therapy requires collaboration between a multidisciplinary team of specialists experienced in the management of these neoplasms. Surgery is the basic form of treatment. Medical therapy requires a multidirectional procedure, and therefore the rules of biotherapy, peptide receptor radionuclide therapy, chemotherapy and molecular targeted therapy are discussed.

Pancreatic Neuroendocrine Tumors: A Literature Review

JOURNAL OF BIOENGINEERING AND TECHNOLOGY APPLIED TO HEALTH, 2020

Pancreatic neuroendocrine tumors (PNETs) affect 1%-3% of patients with pancreatic cancer. This tumor is rare, difficult to diagnose, and clinically laborious. They have an estimated incidence of up to 1 case per 100,000 inhabitants every year. Up on diagnosis, most PNETs are considered malignant, with low healing potential, lesions that are generally unresectable, and a metastasis rate of aproximately 50%. PNETs are classified as functional and non-functional. The tumor functional produces hormones such as gastrin, insulin, somatostatin, glucagon, among others. They are symptomatic due to hormonal hypersecretion and occur in 30% of cases. The other 70% are non-functioning, and despite producing a series of substances and some hormones such as beta HCG and alpha HCG, they are silent tumors, with no significant clinical syndrome. The present study presented scientific evidence about PNETs, the types of pancreas endocrine-tissue tumors, the rate of survival, diagnosis, treatments, and ...