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ECR 2019 / C-3217
Unravelling the 'NET' - imaging of neuroendocrine tumours (NETs) and challenging cases
Congress: ECR 2019
Poster No.: C-3217
Type: Educational Exhibit
Keywords: Abdomen, Gastrointestinal tract, Oncology, Ultrasound, CT, MR, Education, Education and training, Tissue characterisation
Authors: A. Haughey1, C. O Brien1, B. S. Kelly2, J. McCann1; 1Dublin/IE, 2Dublin, Dublin/IE
DOI:10.26044/ecr2019/C-3217

Background

  • What are NETs?
  • Neuroendocrine tumours of the gastrointestinal tract (GI-NETs) comprise a genetically diverse spectrum of malignant neoplasms arising from the secretory cells of the neuroendocrine system.
  • The involved secretory cells produce peptides which may cause characteristic hormonal syndromes in some patients
  • Where do we find them?
  • GI-NETs are most commonly found in the pancreas
  • Certain subtypes arise elsewhere;
    • Gastrinomas primarily affect the pancreas but can also arise in the duodenum, lymph nodes and adrenal glands
    • Vasoactive polypeptide secreting tumours (VIPomas) are primarily pancreatic in origin, but a small percentage are found in the adrenal gland
    • Another atypical location for GI-NETs includes the biliary tree.  These are challenging cases to diagnose and good knowledge of the imaging characteristics is critical in correctly identifying these lesions

 

  • G-NETs are a heterogenous group of neoplasms with varied biological activity and behaviour
  • The clinical course of GI-NETs may be indolent which can lead to a delayed diagnosis, after the development of metastasis 
  • Pretreatment prediction of stage and grade of these neoplasms is important to decide on the best management strategy for the patient
  • How are these lesions treated?
  • Prompt diagnosis of GI-NETs is essential for surgical planning as surgical resection remains the only definitive treatment
  • This is not only reserved for low grade/stage lesions, but will also be considered in some cases presenting with metastatic disease, if it is deemed technically feasible
  • There are several additional treatments available for metastatic GI-NET including; chemoembolization, radiofreqency and medical therapies including somatostatin analogues
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