title: Tailored imaging of islet cell tumors of the pancreas amidst increasing options.
abstract: Pancreatic islet cell tumors are neuroendocrine tumors, which can produce hormones and can arise as part of multiple endocrine neoplasia type 1 or von-Hippel-Lindau-disease, two genetically well-defined hereditary cancer syndromes. Currently, technical innovation improves conventional and specific molecular imaging techniques. To organize the heterogeneous results described for the imaging of these tumors, we distinguished three indications (1) imaging of a patient with hormone hypersecretion, (2) search for a pancreatic primary in case of proven neuroendocrine cancer of unknown primary, and (3) screening of asymptomatic mutation carriers. We searched for publications on imaging of islet cell tumors between 1995 and January 2010 and defined a Level of Evidence (LOE) for the applicability of each technique. For each technique, data were analyzed in a Forest plot and arranged per imaging indication and tumor subtype. LOEs are weak for all imaging techniques. Analyses indicate a prominent role for endoscopic ultrasound for all three indications.
authors.affiliation: Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Helle-Brit
authors.initials: HB
authors.lastname: Fiebrich
authors.forename: Sophie J
authors.initials: SJ
authors.lastname: van Asselt
authors.forename: Adrienne H
authors.initials: AH
authors.lastname: Brouwers
authors.forename: Hendrik M
authors.initials: HM
authors.lastname: van Dullemen
authors.forename: Milan E J
authors.initials: ME
authors.lastname: Pijl
authors.forename: Philip H
authors.initials: PH
authors.lastname: Elsinga
authors.forename: Thera P
authors.initials: TP
authors.lastname: Links
authors.forename: Elisabeth G E
authors.initials: EG
authors.lastname: de Vries
mesh_terms: D006801:Humans; D007515:Islets of Langerhans / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D049268:Positron-Emission Tomography; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed