Pancreatic Imaging

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Key points

  • Most pancreatic neuroendocrine tumors are not “hyperfunctioning.”

  • Imaging alone is not reliable for subtyping neuroendocrine tumors.

  • Pancreatic neuroendocrine tumors are seen in genetic syndromes including multiple endocrine neoplasia I, Von Hippel-Lindau disease, tuberous sclerosis complex, and neurofibramatosis-1.

  • There are numerous imaging mimics of pancreatic neuroendocrine tumors.

  • Imaging may play a role in the future for predicting patients at risk for diabetes mellitus.

Ultrasound Imaging

Transabdominal ultrasound is low yield in pancreatic tumor detection owing to its limited sensitivity and specificity.1, 2 This is likely due to the depth of the organ, variable patient body habitus, and frequent obscuration by air within the stomach and bowel. Despite these limitations, incidental lesions may be detected on routine imaging for nonpancreatic indications and further characterization beyond solid or cystic components is usually not possible. In contrast, pancreas transplants are

Neuroendocrine tumors

Neuroendocrine tumors are found in many different organs. In the pancreas, these tumors are classically associated with clinical syndromes at presentation, but now are increasingly diagnosed as an incidental lesion.18, 19, 20, 21 Often referred to as islet cell tumors, the term is somewhat misleading because it implies that tumors arise de novo from the islets of Langerhans. This nomenclature would also imply that these tumors are α, β, or δ cells gone awry, when in fact most neuroendocrine

Summary

Pancreatic neuroendocrine tumors are a diverse group of neoplasms with many different appearances clinically and at imaging that can range from an incidental finding to a correctable endocrine syndrome to an aggressive malignancy. Understanding the wide array of imaging modalities available to clinicians is important in both making the diagnosis and determining treatment. Imaging may also play a greater role in the future for the evaluation of endocrine insufficiency. Radiologists are available

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