Skip to main content
Top
Published in: Reviews in Endocrine and Metabolic Disorders 3/2021

01-09-2021 | Magnetic Resonance Imaging

Imaging of neuroendocrine tumors: A pictorial review of the clinical value of different imaging modalities

Published in: Reviews in Endocrine and Metabolic Disorders | Issue 3/2021

Login to get access

Abstract

Neuroendocrine tumors (NETs) are multifaceted tumors occurring in a variety of organs and often present as metastatic at the time of diagnosis. Accurate staging is the most significant factor in therapy planning, but it remains a challenge. Imaging is established as the cornerstone for disease detection/diagnosis, staging, and follow up. To accurately assess and monitor tumor burden in patients with NETs, various imaging techniques have been developed and optimized. Current recommendations for the imaging of patients with NETs include a combination of both morphologic (or anatomic) and molecular imaging, but a final choice can be puzzling for clinicians. Recognizing that there is no uniform sequence consensus on the “best” imaging test, and the heterogeneity of technologic availability at different centers, we hope to provide a pictorial review of the different imaging techniques and their role and utility in management of patients with NETs, aimed to provide a practical guide for all clinicians.
Literature
1.
16.
go back to reference Paulsen SR, Huprich JE, Fletcher JG, Booya F, Young BM, Fidler JL et al. CT enterography as a diagnostic tool in evaluating small bowel disorders: review of clinical experience with over 700 cases. Radiographics. 2006;26(3):641–57; discussion 57–62. https://doi.org/10.1148/rg.263055162. Paulsen SR, Huprich JE, Fletcher JG, Booya F, Young BM, Fidler JL et al. CT enterography as a diagnostic tool in evaluating small bowel disorders: review of clinical experience with over 700 cases. Radiographics. 2006;26(3):641–57; discussion 57–62. https://​doi.​org/​10.​1148/​rg.​263055162.
19.
go back to reference Falconi M, Eriksson B, Kaltsas G, Bartsch DK, Capdevila J, Caplin M, et al. ENETS consensus guidelines update for the management of patients with functional pancreatic neuroendocrine tumors and non-functional pancreatic neuroendocrine tumors. Neuroendocrinology. 2016;103(2):153–71. https://doi.org/10.1159/000443171.CrossRefPubMed Falconi M, Eriksson B, Kaltsas G, Bartsch DK, Capdevila J, Caplin M, et al. ENETS consensus guidelines update for the management of patients with functional pancreatic neuroendocrine tumors and non-functional pancreatic neuroendocrine tumors. Neuroendocrinology. 2016;103(2):153–71. https://​doi.​org/​10.​1159/​000443171.CrossRefPubMed
31.
go back to reference van Asselt SJ, Brouwers AH, van Dullemen HM, van der Jagt EJ, Bongaerts AH, Kema IP et al. EUS is superior for detection of pancreatic lesions compared with standard imaging in patients with multiple endocrine neoplasia type 1. Gastrointest Endosc. 2015;81(1):159–67 e2. https://doi.org/10.1016/j.gie.2014.09.037. van Asselt SJ, Brouwers AH, van Dullemen HM, van der Jagt EJ, Bongaerts AH, Kema IP et al. EUS is superior for detection of pancreatic lesions compared with standard imaging in patients with multiple endocrine neoplasia type 1. Gastrointest Endosc. 2015;81(1):159–67 e2. https://​doi.​org/​10.​1016/​j.​gie.​2014.​09.​037.
39.
go back to reference Farchione A, Rufini V, Brizi MG, Iacovazzo D, Larghi A, Massara RM, et al. Evaluation of the added value of diffusion-weighted imaging to conventional magnetic resonance imaging in pancreatic neuroendocrine tumors and comparison with 68Ga-DOTANOC positron emission tomography/computed tomography. Pancreas. 2016;45(3):345–54. https://doi.org/10.1097/mpa.0000000000000461.CrossRefPubMed Farchione A, Rufini V, Brizi MG, Iacovazzo D, Larghi A, Massara RM, et al. Evaluation of the added value of diffusion-weighted imaging to conventional magnetic resonance imaging in pancreatic neuroendocrine tumors and comparison with 68Ga-DOTANOC positron emission tomography/computed tomography. Pancreas. 2016;45(3):345–54. https://​doi.​org/​10.​1097/​mpa.​0000000000000461​.CrossRefPubMed
40.
go back to reference d’Assignies G, Fina P, Bruno O, Vullierme MP, Tubach F, Paradis V, et al. High sensitivity of diffusion-weighted MR imaging for the detection of liver metastases from neuroendocrine tumors: comparison with T2-weighted and dynamic gadolinium-enhanced MR imaging. Radiology. 2013;268(2):390–9. https://doi.org/10.1148/radiol.13121628.CrossRefPubMed d’Assignies G, Fina P, Bruno O, Vullierme MP, Tubach F, Paradis V, et al. High sensitivity of diffusion-weighted MR imaging for the detection of liver metastases from neuroendocrine tumors: comparison with T2-weighted and dynamic gadolinium-enhanced MR imaging. Radiology. 2013;268(2):390–9. https://​doi.​org/​10.​1148/​radiol.​13121628.CrossRefPubMed
41.
42.
go back to reference Sankowski AJ, Cwikla JB, Nowicki ML, Chaberek S, Pech M, Lewczuk A et al. The clinical value of MRI using single-shot echoplanar DWI to identify liver involvement in patients with advanced gastroenteropancreatic-neuroendocrine tumors (GEP-NETs), compared to FSE T2 and FFE T1 weighted image after i.v. Gd-EOB-DTPA contrast enhancement. Med Sci Monit. 2012;18(5):MT33–40. https://doi.org/10.12659/msm.882719. Sankowski AJ, Cwikla JB, Nowicki ML, Chaberek S, Pech M, Lewczuk A et al. The clinical value of MRI using single-shot echoplanar DWI to identify liver involvement in patients with advanced gastroenteropancreatic-neuroendocrine tumors (GEP-NETs), compared to FSE T2 and FFE T1 weighted image after i.v. Gd-EOB-DTPA contrast enhancement. Med Sci Monit. 2012;18(5):MT33–40. https://​doi.​org/​10.​12659/​msm.​882719.
46.
go back to reference Reubi JC, Schar JC, Waser B, Wenger S, Heppeler A, Schmitt JS, et al. Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med. 2000;27(3):273–82.CrossRefPubMed Reubi JC, Schar JC, Waser B, Wenger S, Heppeler A, Schmitt JS, et al. Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med. 2000;27(3):273–82.CrossRefPubMed
50.
go back to reference Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92(3):205–16. https://doi.org/10.1093/jnci/92.3.205. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92(3):205–16. https://​doi.​org/​10.​1093/​jnci/​92.​3.​205.
62.
go back to reference Hofman MS, Hicks RJ. Changing paradigms with molecular imaging of neuroendocrine tumors. Discov Med. 2012;14(74):71–81.PubMed Hofman MS, Hicks RJ. Changing paradigms with molecular imaging of neuroendocrine tumors. Discov Med. 2012;14(74):71–81.PubMed
65.
go back to reference Adams S, Baum R, Rink T, Schumm-Drager PM, Usadel KH, Hor G. Limited value of fluorine-18 fluorodeoxyglucose positron emission tomography for the imaging of neuroendocrine tumours. Eur J Nucl Med. 1998;25(1):79–83.CrossRefPubMed Adams S, Baum R, Rink T, Schumm-Drager PM, Usadel KH, Hor G. Limited value of fluorine-18 fluorodeoxyglucose positron emission tomography for the imaging of neuroendocrine tumours. Eur J Nucl Med. 1998;25(1):79–83.CrossRefPubMed
66.
go back to reference Belhocine T, Foidart J, Rigo P, Najjar F, Thiry A, Quatresooz P, et al. Fluorodeoxyglucose positron emission tomography and somatostatin receptor scintigraphy for diagnosing and staging carcinoid tumours: correlations with the pathological indexes p53 and Ki-67. Nucl Med Commun. 2002;23(8):727–34.CrossRefPubMed Belhocine T, Foidart J, Rigo P, Najjar F, Thiry A, Quatresooz P, et al. Fluorodeoxyglucose positron emission tomography and somatostatin receptor scintigraphy for diagnosing and staging carcinoid tumours: correlations with the pathological indexes p53 and Ki-67. Nucl Med Commun. 2002;23(8):727–34.CrossRefPubMed
72.
82.
go back to reference Gaertner FC, Beer AJ, Souvatzoglou M, Eiber M, Furst S, Ziegler SI, et al. Evaluation of feasibility and image quality of 68Ga-DOTATOC positron emission tomography/magnetic resonance in comparison with positron emission tomography/computed tomography in patients with neuroendocrine tumors. Invest Radiol. 2013;48(5):263–72. https://doi.org/10.1097/RLI.0b013e31828234d0.CrossRefPubMed Gaertner FC, Beer AJ, Souvatzoglou M, Eiber M, Furst S, Ziegler SI, et al. Evaluation of feasibility and image quality of 68Ga-DOTATOC positron emission tomography/magnetic resonance in comparison with positron emission tomography/computed tomography in patients with neuroendocrine tumors. Invest Radiol. 2013;48(5):263–72. https://​doi.​org/​10.​1097/​RLI.​0b013e31828234d0​.CrossRefPubMed
95.
go back to reference Bostancı EB, Oter V, Okten S, Küçük NO, Soydal C, Turhan N, et al. Intra-pancreatic Accessory Spleen Mimicking Pancreatic Neuroendocrine Tumor on 68-Ga-Dotatate PET/CT. Arch Iran Med. 2016;19(11):816–9.PubMed Bostancı EB, Oter V, Okten S, Küçük NO, Soydal C, Turhan N, et al. Intra-pancreatic Accessory Spleen Mimicking Pancreatic Neuroendocrine Tumor on 68-Ga-Dotatate PET/CT. Arch Iran Med. 2016;19(11):816–9.PubMed
97.
go back to reference Royal HD, Brown ML, Drum DE, Nagle CE, Sylvester JM, Ziessman HA. Procedure guideline for hepatic and splenic imaging. Society of Nuclear Medicine. J Nucl Med. 1998;39(6):1114–6. Royal HD, Brown ML, Drum DE, Nagle CE, Sylvester JM, Ziessman HA. Procedure guideline for hepatic and splenic imaging. Society of Nuclear Medicine. J Nucl Med. 1998;39(6):1114–6.
110.
go back to reference Pavel M, O’Toole D, Costa F, Capdevila J, Gross D, Kianmanesh R, et al. ENETS Consensus Guidelines Update for the Management of Distant Metastatic Disease of Intestinal, Pancreatic, Bronchial Neuroendocrine Neoplasms (NEN) and NEN of Unknown Primary Site. Neuroendocrinology. 2016;103(2):172–85. https://doi.org/10.1159/000443167.CrossRefPubMed Pavel M, O’Toole D, Costa F, Capdevila J, Gross D, Kianmanesh R, et al. ENETS Consensus Guidelines Update for the Management of Distant Metastatic Disease of Intestinal, Pancreatic, Bronchial Neuroendocrine Neoplasms (NEN) and NEN of Unknown Primary Site. Neuroendocrinology. 2016;103(2):172–85. https://​doi.​org/​10.​1159/​000443167.CrossRefPubMed
112.
Metadata
Title
Imaging of neuroendocrine tumors: A pictorial review of the clinical value of different imaging modalities
Publication date
01-09-2021

Other articles of this Issue 3/2021

Reviews in Endocrine and Metabolic Disorders 3/2021 Go to the issue