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. 2015;2(2):159-168.
doi: 10.2217/ije.14.40.

Imaging in neuroendocrine tumors: an update for the clinician

Jessica E Maxwell  1 , James R Howe  1
Affiliations

Imaging in neuroendocrine tumors: an update for the clinician

Jessica E Maxwell et al. Int J Endocr Oncol. 2015.

Abstract

Neuroendocrine tumors are a heterogeneous group of neoplasms that are best worked up and managed using a variety of clinical and imaging studies. They are often diagnosed after they have already metastasized, though this does not necessarily preclude an attempt at curative surgical treatment or surgical debulking. Tumor burden assessment often requires use of multiple imaging modalities including computed tomography, magnetic resonance imaging and ultrasound. Somatostatin receptor-based imaging is also of great utility in looking for primaries and determining the extent of metastatic disease. This paper will review the most common imaging modalities used in the diagnosis and treatment of neuroendocrine tumors.

Keywords: 68Ga-DOTANOC; 68Ga-DOTATOC; CT; MRI; NET; OctreoScan; PET; neuroendocrine tumor; somatostatin imaging; ultrasound.

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Figures

Figure 1
Figure 1. Triple phase CT scan demonstrating approximately 70% replacement of the liver by enhancing neuroendocrine tumor metastases
(A) Arterial phase, (B) venous phase and (C) equilibrium phase of delayed images. Note that hyperenhancing lesions are most clearly seen on arterial phase.
Figure 2
Figure 2. Hepatic neuroendocrine tumor metastases demonstrated on axial T1 weighted fat-suppressed postgadolinium images
(A) Axial image, early arterial phase and (B) coronal image, portal venous phase. Arrows indicate large hepatic metastases.
Figure 3
Figure 3. Comparison of (A) planar OctreoScan, (B) fused OctreoScan/SPECT/CT, (C) planar 68Ga-DOTATOC PET and (D) 68Ga-DOTATOC PET/CT in the same patient
The patient has approximately 33% of their liver replaced by neuroendocrine tumor metastases. The images in (C) and (D) provide more precise delineation of lesions, compared with (A) and (B).
Figure 4
Figure 4. 68Ga-DOTATOC demonstrating multiple metastases in the upper and lower extremities, liver and right lower quadrant in a patient with an SBNET primary
Physiologic uptake is seen in the pituitary, kidneys, spleen and bladder.
See this image and copyright information in PMC

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