Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Jan 9;13(2):239.
doi: 10.3390/diagnostics13020239.

Contrast Enhanced EUS for Predicting Solid Pancreatic Neuroendocrine Tumor Grade and Aggressiveness

Gianluca Franchellucci  1   2 , Marta Andreozzi  3   4 , Silvia Carrara  3 , Luca De Luca  5 , Francesco Auriemma  1 , Danilo Paduano  1 , Federica Calabrese  1 , Antonio Facciorusso  6 , Valeria Poletti  1   2 , Alessandro Zerbi  2   7 , Andrea Gerardo Lania  8 , Alexia Francesca Bertuzzi  9 , Paola Spaggiari  10 , Vittorio Pedicini  11 , Marcello Rodari  12 , Pietro Fusaroli  13 , Andrea Lisotti  13 , Andrew Ofosu  14 , Alessandro Repici  2   3 , Benedetto Mangiavillano  1   2
Affiliations
Review

Contrast Enhanced EUS for Predicting Solid Pancreatic Neuroendocrine Tumor Grade and Aggressiveness

Gianluca Franchellucci et al. Diagnostics (Basel). .

Abstract

Pancreatic neuroendocrine tumor (PNET) behavior assessment is a daily challenge for physicians. Modern PNET management varies from a watch-and-wait strategy to surgery depending on tumor aggressiveness. Therefore, the aggressiveness definition plays a pivotal role in the PNET work-up. The aggressiveness of PNETs is mainly based on the dimensions and histological grading, with sometimes a lack of specificity and sensibility. In the last twenty years, EUS has become a cornerstone in the diagnostic phase of PNET management for its high diagnostic yield and the possibility of obtaining a histological specimen. The number of EUS applications in the PNET work-up has been rapidly increasing with new and powerful possibilities. The application of contrast has led to an important step in PNET detection; in recent years, it has been gaining interesting applications in aggressiveness assessment. In this review, we underline the latest experiences and opportunities in the behavior assessment of PNETs using contact-enhanced EUS and contested enhanced harmonic EUS with a particular focus on the future application and possibility that these techniques could provide.

Keywords: CE-EUS; CH-EUS; EUS; NET; PNET; aggressiveness; grading.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A hypoechoic lesion of 21 mm with regular margins (identified by the blu +) and an ipoechoic appearance; at histopathological analysis the lesion was a G1 NET.
Figure 2
Figure 2
PNET with high lesion-to-parenchyma strain ratio, characterized as G2 with lymphatic invasion at the histological analysis of the surgical specimen.
Figure 3
Figure 3
An example of the PNET EUS appearance with and without contrast (Sonovue). In the right picture, there is a hypo-isoechoic lesion while in the picture on the left, the hyperenhancement of the same lesion could be appreciated after intravenous contrast administration. Red arrows delineate the edge of the lesions. After FNAB, the solid lesion was characterized as G1-PNET.
See this image and copyright information in PMC

References

    1. Pavel M., Öberg K., Falconi M., Krenning E.P., Sundin A., Perren A., Berruti A., ESMO Guidelines Committee Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 2020;31:844–860. doi: 10.1016/j.annonc.2020.03.304. - DOI - PubMed
    1. Frilling A., Akerström G., Falconi M., Pavel M., Ramos J., Kidd M., Modlin I.M. Neuroendocrine tumor disease: An evolving landscape. Endocr. Relat. Cancer. 2012;19:R163–R185. doi: 10.1530/ERC-12-0024. - DOI - PubMed
    1. Xu Z., Wang L., Dai S., Chen M., Li F., Sun J., Luo F. Epidemiologic Trends of and Factors Associated With Overall Survival for Patients With Gastroenteropancreatic Neuroendocrine Tumors in the United States. JAMA Netw. Open. 2021;4:e2124750. doi: 10.1001/jamanetworkopen.2021.24750. - DOI - PMC - PubMed
    1. Stensbøl A.B., Krogh J., Holmager P., Klose M., Oturai P., Kjaer A., Hansen C.P., Federspiel B., Langer S.W., Knigge U., et al. Incidence, Clinical Presentation and Trends in Indication for Diagnostic Work-Up of Small Intestinal and Pancreatic Neuroendocrine Tumors. Diagnostics. 2021;11:2030. doi: 10.3390/diagnostics11112030. - DOI - PMC - PubMed
    1. Rindi G., Klimstra D.S., Abedi-Ardekani B., Asa S.L., Bosman F.T., Brambilla E., Busam K.J., de Krijger R.R., Dietel M., El-Naggar A., et al. A common classification framework for neuroendocrine neoplasms: An International Agency for Research on Cancer (IARC) and World Health Organization (WHO) expert consensus proposal. Mod. Pathol. 2018;31:1770–1786. doi: 10.1038/s41379-018-0110-y. - DOI - PMC - PubMed

LinkOut - more resources