Learning objectives
To focus on the imaging techniques that used in the diagnosis,
staging and follow-up of neuroendocrine tumors.
To overview the conventional and the somatostatin-based imaging techniques that make the workup of NET.
Background
Neuroendocrine tumors (NETs) arise from the diffuse neuroendocrine system eg skin,
lung,
the hepatobiliary system,..etc.
The most common primary sites are the lung,
rectum and small bowel.
They may cause symptoms (depending on hormonal secretions) such as diarrhea or flushing.
Could be diagnosed using a variety of clinical and imaging studies,
unfortunately already after metastasized.
Assessment often requires use of multiple imaging modalities including computed tomography,
magnetic resonance imaging and ultrasound; arising the need for hybrid imaging.
Somatostatin receptor-based imaging would be the diagnostic cornerstone.
Findings and procedure details
I.
Conventional:Computed tomography CT
CT scans are usually the initial imaging study.
PROS:
Would be anatomical useful modality for disease staging and surgical planning.
Primary NETs and their metastases are generally hyper-enhancing,
best seen in the arterial phase of a triple phase CT scan
Useful for operative planning,
disease staging
CONS:
Not a functional study; weak in detection of the primary in 95% of cases
High radiation exposure
Optimal imaging of NETs requires IV contrast
Magnetic resonance imaging
PROS:
MRI is the best to detail...
Conclusion
the best diagnostic outcome of neuroendocrine tumors requires use of a combination of conventional and somatostatin-based imaging techniques; hybrid imaging.
Personal information
contact me in email:
[email protected]
thanks to the Umeahospitalteam for their support
References
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