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Abdom Radiol (NY). 2019 Apr 12. doi: 10.1007/s00261-019-01994-5. [Epub ahead of print]

The role of multimodal imaging in guiding resectability and cytoreduction in pancreatic neuroendocrine tumors: focus on PET and MRI.

Author information

1
Sorbonne Université, Service de Médecine Nucléaire, AP-HP, Hôpital La Pitié-Salpêtrière, 75013, Paris, France.
2
Radiology Department, Toulouse University Hospital, 1 Avenue du Professeur Jean Poulhes, 31059, Toulouse, France.
3
Department of Radiology, New York Presbyterian Hospital, Columbia University, New York, NY, USA.
4
Memorial Sloan Kettering Cancer Center, Molecular Imaging and Therapy Service, New York, NY, USA.
5
Department of Imaging and Nuclear Medicine, Institut Claudius Regaud - Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France.
6
Paris Sud University, Kremlin Bicêtre Hospital, Paris, France.
7
Department of Nuclear Medicine, Institut Curie-René Huguenin, Saint-Cloud, France.
8
Department of Endocrine Oncology, Hôpital Saint Louis, Paris, France.
9
Department of Radiology, New York Presbyterian Hospital, Columbia University, New York, NY, USA. ld2752@cumc.columbia.edu.
10
UMR 1015, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, 94805, France. ld2752@cumc.columbia.edu.

Abstract

Pancreatic neuroendocrine tumors (pNETs) are rare neoplasms that secrete peptides and neuro-amines. pNETs can be sporadic or hereditary, syndromic or non-syndromic with different clinical presentations and prognoses. The role of medical imaging includes locating the tumor, assessing its extent, and evaluating the feasibility of curative surgery or cytoreduction. Pancreatic NETs have very distinctive phenotypes on CT, MRI, and PET. PET have been demonstrated to be very sensitive to detect either well-differentiated pNETs using 68Gallium somatostatin receptor (SSTR) radiotracers, or more aggressive undifferentiated pNETS using 18F-FDG. A comprehensive interpretation of multimodal imaging guides resectability and cytoreduction in pNETs. The imaging phenotype provides information on the differentiation and proliferation of pNETs, as well as the spatial and temporal heterogeneity of tumors with prognostic and therapeutic implications. This review provides a structured approach for standardized reading and reporting of medical imaging studies with a focus on PET and MR techniques. It explains which imaging approach should be used for different subtypes of pNET and what a radiologist should be looking for and reporting when interpreting these studies.

KEYWORDS:

Neuroendocrine tumors; PET-CT; Somatostatin receptors; Theranostics

PMID:
30980115
DOI:
10.1007/s00261-019-01994-5

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