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ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Radiological, Nuclear Medicine & Hybrid Imaging.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
Philipps Univ, Dept Gastroenterol & Endocrino.
Gustave Roussy Canc Campus, Dept Endocrine Oncol & Nucl Med.
Univ Warmia & Mazury, Fac Med Sci, Dept Radiol.
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2017 (English)In: Neuroendocrinology, ISSN 0028-3835, E-ISSN 1423-0194, Vol. 105, no 3, p. 212-244Article in journal (Refereed) Published
Abstract [en]

Contrast-enhanced computed tomography (CT) of the neckthorax-abdomen and pelvis, including 3-phase examination of the liver, constitutes the basic imaging for primary neuroendocrine tumor (NET) diagnosis, staging, surveillance, and therapy monitoring. CT characterization of lymph nodes is difficult because of inadequate size criteria (short axis diameter), and bone metastases are often missed. Contrast-enhanced magnetic resonance imaging (MRI) including diffusion-weighted imaging is preferred for the examination of the liver, pancreas, brain and bone. MRI may miss small lung metastases. MRI is less well suited than CT for the examination of extended body areas because of the longer examination procedure. Ultrasonography (US) frequently provides the initial diagnosis of liver metastases and contrast-enhanced US is excellent to characterize liver lesions that remain equivocal on CT/MRI. US is the method of choice to guide the biopsy needle for the histopathological NET diagnosis. US cannot visualize thoracic NET lesions for which CTguided biopsy therefore is used. Endocopic US is the most sensitive method to diagnose pancreatic NETs, and additionally allows for biopsy. Intraoperative US facilitates lesion detection in the pancreas and liver. Somatostatin receptor imaging should be a part of the tumor staging, preoperative imaging and restaging, for which 68 Ga-DOTA-somatostatin analog PET/CT is recommended, which is vastly superior to somatostatin receptor scintigraphy, and facilitates the diagnosis of most types of NET lesions, for example lymph node metastases, bone metastases, liver metastases, peritoneal lesions, and primary small intestinal NETs. (18)FDG-PET/CT is better suited for G3 and high G2 NETs, which generally have higher glucose metabolism and less somatostatin receptor expression than low-grade NETs, and additionally provides prognostic information.

Place, publisher, year, edition, pages
2017. Vol. 105, no 3, p. 212-244
Keyword [en]
Neuroendocrine tumor, Computed tomography, Magnetic resonance imaging, Ultrasound, Positron emission tomography, Scintigraphy, Single photon emission computed tomography, Somatostatin receptor imaging
National Category
Medical and Health Sciences Endocrinology and Diabetes Neurosciences
Identifiers
URN: urn:nbn:se:uu:diva-319611DOI: 10.1159/000471879ISI: 000411501200004PubMedID: 28355596OAI: oai:DiVA.org:uu-319611DiVA, id: diva2:1087247
Available from: 2017-04-06 Created: 2017-04-06 Last updated: 2018-01-13Bibliographically approved

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Sundin, AndersEriksson, Barbro

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