Neuroendocrine tumors are a type of heterogeneous tumors originating from neuroendocrine cells derived from the neural crest，which can secrete a variety of amines and peptide hormones.Based on different molecular biomarkers，histologic types and differentiation degrees，individualized nuclear imaging can provide information for the early diagnosis，clinical staging，treatment guidance，and detection of the recurrence and metastasis of neuroendocrine tumor. In this paper，we review the development and application of nuclear medicine molecular imaging probes such as glucose analogs，somatostatin analogues，amine precursors，hormone analogs and enzyme inhibitors in the diagnosis and treatment of neuroendocrine tumors.
Diagnostic Imaging ; Humans ; Molecular Probes ; Neoplasm Recurrence, Local ; Neuroendocrine Tumors/diagnostic imaging* ; Radionuclide Imaging

Liver metastasis is not rare during the course of neuroendocrine neoplasms.The methods for treating neuroendocrine neoplasm with liver metastasis(NENLM)are diversifying,which exposes the limitations of the early therapeutic response assessment based on only morphological changes.The emerging imaging biomarkers can sensitively describe changes in response to treatment from the functional level,providing new ideas for the therapeutic response evaluation of NENLM.In this paper,we reviewed the status quo and the latest research progress of imaging assessment for early therapeutic response of NENLM,aiming to provide reference for assessing the response and further exploring the treatment-related biomarkers.
Diagnostic Imaging ; Humans ; Liver Neoplasms/diagnostic imaging* ; Neoplasm Metastasis ; Neuroendocrine Tumors/diagnostic imaging*

Primary malignant small bowel tumor as a rare kind of intestinal tumor is associated with a poor prognosis. The pathological types were various and complicated, such as adenocarcinoma, neuroendocrine tumor, malignant lymphoma, and malignant stromal tumor. The atypical early stage symptom resulted in difficult diagnosis at early stage, high misdiagnosis rate and lack of standard therapy schemes and means. In the past, X-ray, CT, MRI, and PET-CT were the main examination methods for primary small bowel tumor. However, with the development of radiology, a series of new diagnosis methods, including electronic enteroscopy, capsule endoscopy, multi-slice spiral CT enteroclysis and so on, promotes the diagnosis accurate rate. Surgery is still the most important method in the small bowel tumor treatment, and the alternative of the surgical method should depend on the tumor location, size and relationship with the adjacent organs. Application of the laparoscopic surgery for the small bowel tumor is still in the initial stage. Besides, some researches have confirmed that chemotherapy, radiotherapy, target therapy and endocrinotherapy have effects on the specific kind of small bowel tumor. Therefore this article will review the epidemiology, pathology, diagnosis and treatment of the primary malignant small bowel tumors.
Adenocarcinoma ; diagnosis ; epidemiology ; pathology ; therapy ; Capsule Endoscopy ; Gastrointestinal Stromal Tumors ; diagnosis ; epidemiology ; pathology ; therapy ; Humans ; Intestinal Neoplasms ; diagnosis ; epidemiology ; pathology ; therapy ; Intestine, Small ; diagnostic imaging ; pathology ; Laparoscopy ; methods ; Lymphoma ; diagnosis ; epidemiology ; pathology ; therapy ; Neuroendocrine Tumors ; diagnosis ; epidemiology ; pathology ; therapy ; Tomography, Spiral Computed

Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are neoplasms presenting unpredictable and unusual biologic behavior that causes many clinical challenges. NETs can produce a variety of metabolically active substances (hormones and amines) leading to distinct clinical syndromes. This review will discuss the imaging techniques for the diagnosis of GEP-NETs including ultrasonography, CT, MRI and ultrasound endoscope. In this article, Gallium-68 labeled peptide binding to G protein coupled receptor including SSTR, CCKR1 and GLP1R is addressed, and the application of Gallium-68 labeled somatostin analogues and PET-CT for diagnosis of GEP-NETs is evaluated. In conclusion, Gallium-68 labeled peptide and molecular imaging will play important roles in diagnosis, prognosis and therapeutic strategy development of GEP-NETs.
Diagnostic Imaging ; methods ; Endoscopy ; Gallium Radioisotopes ; chemistry ; Humans ; Intestinal Neoplasms ; diagnosis ; Magnetic Resonance Imaging ; Neuroendocrine Tumors ; diagnosis ; Pancreatic Neoplasms ; diagnosis ; Prognosis ; Receptors, G-Protein-Coupled ; chemistry ; Stomach Neoplasms ; diagnosis ; Tomography, X-Ray Computed ; Ultrasonography

Objective To compare the sensitivity of multislice spiral CT dual phase and somatosatatin receptor scintigraphy (SRS) in the diagnosis of pancreas nuroendocrine tumors (pNET). Methods Totally 28 patients with pathologically confirmed pNET recieved both CT dual phase contrast and SRS and the results were compared. Results Of these 28 pNET patients,26 (92.8%) were accurately diagnosed by CT dual-phase scan and 20 (71.4%) by SRS (P＝0.031).In the functioning pNET cases,the diagnosis sensitivity of CT dual phase scan and SRS was 94.1% (16/17)and 58.8% (10/17)(P＝0.218). In the non-functioning pNET cases,the sensitivity was 90.9% (10/11) and 90.9% (10/11) (P＝0.740).Diagnostic sensitivity of CT dual phase scan and SRS for pNET without metastasis was 90.4% (19/21) and 57.1% (12/21) (P＝0.125).The sensitivity for pNET with metastasis was 100%(7/7)and 100% (7/7). Corresponding to the pathological grading,the diagnostic sensitivity of CT dual phase scanning and SRS was 84.6% (11/13) and 53.8% (7/13) for G1,100% (12/12) and 83.3% (10/12) for G2,and 100% (3/3) and 100% (3/3) for G3. The diagnostic sensitivity of CT dual phase scan and SRS for pNET with diameter less than or equal to 2.0 cm was 94.7% (18/19) and 52.6% (10/19) (P＝0.008). For pNET with diameter more than 2.0 cm,the sensitivity was 92.8% (13/14) and 100% (14/14). Conclusions Compared with SRS,dual phase CT scan is more sensitive in diagnosing pNET,especially for those in lower pathological stages. For lesions sized less than or equal to 2.0 cm,SRS should be combined with other imaging examinations to minimize false negative results.
Humans ; Neuroendocrine Tumors ; diagnostic imaging ; Pancreatic Neoplasms ; diagnostic imaging ; Radionuclide Imaging ; Sensitivity and Specificity ; Tomography, Spiral Computed

OBJECTIVETo investigate the diagnostic value of liquid-based cytology test (LCT) in pancreatic lesions sampled by ultrasound-guided fine needle aspiration (EUS-FNA).

METHODSA retrospective analysis of 556 cases of LCT smears sampled by EUS-FNA of pancreatic lesions was performed, and 164 cases had histologic diagnosis with subsequent surgical resection or biopsy and immunohistochemistry. The accuracy of the cytologic diagnosis was assessed using the histologic diagnosis as the gold standard. The discrepant cases were reviewed to identify sources of errors.

RESULTSThe satisfactory rate for EUS-FNA was 96.0%(534/556). The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 87.7%(128/146), 13/16, 97.7%(128/131), 41.9%(13/31) and 87.0%(141/162) respectively. The diagnostic accuracy was lower in cystic lesions than that in solid lesions. The LCT sensitivities of adenocarcinoma, lymphoma and neuroendocrine tumors were higher than those of cystic tumors and mesenchymal tumors. False positive diagnosis was mainly due to epithelial abnormalities in inflammatory reaction. False negative diagnosis was mainly due to scanty or lack of tumor cells in the smears, or mild atypia that was insufficient for diagnosis.

CONCLUSIONSEUS-FNA is a valuable tool for the diagnosis of pancreatic lesions. Standardized terminology and nomenclature are helpful to improve the diagnostic accuracy.

Adenocarcinoma ; diagnosis ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Humans ; Inflammation ; Neoplasms, Connective and Soft Tissue ; diagnosis ; Neuroendocrine Tumors ; diagnosis ; Pancreas ; cytology ; diagnostic imaging ; pathology ; Pancreatic Neoplasms ; diagnosis ; Retrospective Studies ; Sensitivity and Specificity ; Specimen Handling

Multiple endocrine neoplasia type 1 (MEN1) is an inherited autosomal dominant disease presenting with pancreatic neuroendocrine tumors (pNETs), parathyroid tumors, or pituitary tumors. Using the PubMed database, we reviewed the literature on information regarding the proper diagnosis and treatment of MEN1-associated pNET. Many cases of MEN1-associated pNET are functioning pNETs. Gastrinomas and insulinomas tend to occur frequently in the duodenum and pancreas, respectively. In addition to diagnostic imaging, the selective arterial secretagogue injection test (SASI test) is useful for localizing functioning pNET. The standard treatment is surgical resection. However, in the case of a functioning pNET, the tumor should first be accurately located using the SASI test before an appropriate surgical method is selected. In cases of a MEN1-associated non-functioning pNET that exceeds 2 cm in diameter, the incidence of distant metastasis is significantly increased, and surgery is recommended. In cases of unresectable pNET, a somatostatin analog has been shown to demonstrate antitumor effects and is considered to be a promising treatment. In addition, molecular-targeted drugs have recently been found to be effective in phase III clinical trials.
Diagnostic Imaging ; Duodenum ; Gastrinoma ; Incidence ; Insulinoma ; Multiple Endocrine Neoplasia ; Multiple Endocrine Neoplasia Type 1 ; Neoplasm Metastasis ; Neuroectodermal Tumors, Primitive ; Neuroendocrine Tumors ; Pancreas ; Pituitary Neoplasms ; Somatostatin

OBJECTIVEThis pictorial review aimed to summarize the most possible differential diagnosis of pancreatic islet cell tumor (PICT).

DATA SOURCESData used in this review were mainly from Medline and Pubmed in English. And all clinical images in this review were from Department of Radiology, Peking Union Medical College Hospital, Beijing, China.

STUDY SELECTIONCases of pancreatic cystadenoma, solid pseudo-papillary tumor of the pancreas, pancreatic metastasis, pancreatic adenocarcinoma, para-pancreatic neuroendocrine tumors, Castleman disease, gastrointestinal stromal tumor, splenic artery aneurysm and accessory spleen were selected in this pictorial review for differential diagnosis of PICT.

RESULTSCareful analysis of imaging features and correlation with the clinical manifestations may allow a more specific diagnosis. It is also important that the radiologist is familiar with the anatomic variants and disease entities which mimic pancreatic islet cell tumor in order to avoid an improper treatment protocol.

CONCLUSIONSMany congenital anatomic variants or other pancreatic and peri-pancreatic diseases may mimic MDCT appearance of pancreatic islet cell tumor. Radiological, clinical and pathological characteristics should be considered for the final diagnosis.

Humans ; Neuroendocrine Tumors ; diagnosis ; diagnostic imaging ; Pancreatic Neoplasms ; diagnosis ; diagnostic imaging ; Radiography

No abstract available.
Aged ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Liver Neoplasms/*diagnosis/pathology/secondary ; Magnetic Resonance Imaging ; Male ; Neuroendocrine Tumors/*diagnosis/radionuclide imaging/secondary ; Pancreatic Neoplasms/*diagnosis/pathology/radionuclide imaging ; Positron-Emission Tomography ; Tomography, X-Ray Computed

No abstract available.
Aged ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Liver Neoplasms/*diagnosis/pathology/secondary ; Magnetic Resonance Imaging ; Male ; Neuroendocrine Tumors/*diagnosis/radionuclide imaging/secondary ; Pancreatic Neoplasms/*diagnosis/pathology/radionuclide imaging ; Positron-Emission Tomography ; Tomography, X-Ray Computed