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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

Findings and procedure details


  • Imaging Features:
  • Classical imaging features of GI-NETs:
    • Well-circumscribed round or oval in shape
    • Hypoechoic echotexture on ultrasound 
      • Conversely neuroendocrine liver metastases are typically hyperechoic on ultrasound
    • GI-NETs are homogenously hypervascular tumours and their appearance on computed tomography (CT) follows a pattern of low attenuation on non-contrast studies to hyperattenuation on late arterial phase imaging with decreased enhancement on portal venous and delayed phase studies
    • Magnetic Resonance Imaging offers superior intrinsic soft-tissue contrast.  Most GI-NETs demonstrate low signal on T1-weighted imaging and high signal intensity on T2-weighted imaging
    • GI-NETs are generally hypervascular in the arterial phase on contrast-enhanced imaging, but their appearance on MRI will depend on the presence/absence of necrosis or cystic degeneration


  • Imaging Features Suggestive of a Higher Grade or Stage:


  • Large lesions
  • Ill-defined margins
  • Heterogenous enhancement - heterogeneous enhancement is significantly more common among higher grade lesions
  • Lesions with heterogeneous enhancement are generally significantly larger in size than those demonstrating homogeneous enhancement
  • ADC values on DWI – Higher grade and stage lesions have significantly lower mean ADC values compared to low grade or early stage lesions



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