Do you know which functional pancreatic NETs are malignant and which are benign? How about the best type of imaging for identifying the occult primary site in small-volume NET disease? Test your knowledge in our latest quiz.
Do you know which functional pancreatic neuroendocrine tumors (NETs) are malignant and which are benign? How about the best type of imaging for identifying the occult primary site in small-volume NET disease? Test your knowledge in our latest quiz.
Patients in whom metastatic disease is suspected should be evaluated with a triple-phase contrast-enhanced helical computer tomography (CT) scan or a magnetic resonance imaging (MRI) scan to rule out liver metastases. Some clinicians prefer MRI because of its greater sensitivity for liver metastases.
These slow-growing tumors can grow in the head, body, or tail of the pancreas, in the cells that make insulin. These tumors are usually benign, according to the National Cancer Institute.
B. Gallium-68 DOTATATE PET/CT
Uptake of radiolabeled somatostatin analogs is predictive of a clinical response to therapy with somatostatin analogs and to peptide receptor radionuclide therapy, and it can assist in identifying an otherwise occult primary site. The greater sensitivity of gallium-68 DOTATATE PET/CT suggests that when available it may be preferred over indium-111 pentetreotide (OctreoScan) in certain clinical settings (such as small-volume disease).
While most carcinoid tumors occur in the small intestine (39%), they can also occur in the rectum (15%), bronchial system of the lungs (10%), appendix (7%), colon (5% to 7%), stomach (2% to 4%), pancreas (2% to 4%), and liver (1%). They rarely occur in other organs.
High levels of serotonin and chromogranin-A can be found in the blood of patient’s with typical lung carcinoid tumors. In patients with atypical lung carcinoid tumors, normal levels of serotonin and chromogranin-A are present in the blood.