Background: Radiological and nuclear medical diagnostics play an important role in the work-up of patients with gastroenteropancreatic neuroendocrine tumors (GEP-NET). The sonographic examination, including contrast-enhanced examination, depicts an initial imaging modality to screen for NET. This report describes the sonomorphological behavior of ileal and pancreatic NET as well as hepatic metastases from NET.
Clinical/methodical issue: Sonographic evaluation of NET of the small intestine, pancreas and neuroendocrine hepatic metastases.
Standard radiological methods: Contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI), unenhanced ultrasonography.
Methodical innovations: Contrast-enhanced ultrasound (CEUS).
Performance: CEUS supports unenhanced ultrasound in the detection of NET and the differential diagnosis of unclear lesions, and is more sensitive for liver metastases (sensitivity according to the literature, 99% vs. 68%) PRACTICAL RECOMMENDATIONS: CEUS allows initial evaluation of NET and differentiation of benign vs. malignant lesions. Nevertheless, CEUS cannot replace more elaborate imaging modalities like CT or MRI for thorough staging examinations.
Keywords: Contrast-enhanced ultrasound; Differential diagnosis; Gastroenteropancreatic neuroendocrine tumors; Liver metastasis; Staging.