title: Imaging of neuroendocrine tumors of the pancreas.
abstract: Pancreatic neuroendocrine tumors (PNETs) are rare and represent a heterogeneous disease. PNET can be functioning or non-functioning with different clinical presentations and different prognosis based on WHO and pTNM classifications. The role of imaging includes the localization of small functioning tumor, differentiation of these tumors from adenocarcinoma, identification of signs of malignancy and evaluation of extent. PNETs have a broad spectrum of appearance. On CT and MRI, most of functioning PNETs are well defined small tumors with intense and homogeneous enhancement on arterial and portal phases. However, some PNETs with a more fibrous content may have a more delayed enhancement that is best depicted on the delayed phase. Other PNETs can present as purely cystic, complex cystic and solid tumors and calcified tumors. Non-functioning PNETs are larger with less intense and more heterogeneous enhancement. Functional imaging is useful for disease staging, to detect disease recurrence or the primary but also to select patient candidate for peptide receptor radiometabolic treatment. Somatostatin receptor scintigraphy (SRS) (Octreoscan®) is still the most available technique. Gallium 68-SST analogue PET have been demonstrated to be more sensitive than SRS-SPEC and it will be the future of functional imaging for NET. Finally,18FDG PET/CT is indicated for more aggressive PNET as defined either by negative SRS and huge tumor burden or ki67 above 10% or poorly differentiated PNEC tumors.
authors.affiliation: Service de radiodiagnostic et radiologie interventionnelle, bureau CIBM 09-084, rue Bugnon 46, 1011 Lausanne, Switzerland. Electronic address: Clarisse.Dromain@chuv.ch.
authors.forename: C
authors.initials: C
authors.lastname: Dromain
authors.affiliation: Imaging department, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Déandréis
authors.affiliation: Anapathology department, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Scoazec
authors.affiliation: Surgery department, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Goere
authors.affiliation: Imaging department, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Ducreux
authors.affiliation: Oncology department, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Baudin
authors.affiliation: Imaging department, Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Tselikas
mesh_terms: D019160:Endosonography; D015408:Gastrinoma / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007340:Insulinoma / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D011379:Prognosis; D014057:Tomography, X-Ray Computed
keywords: Computed tomography; Magnetic resonance imaging; Neuroendocrine tumor; Pancreas; Pancreatic malignancies