Table 3.
The sensitivity, advantages and disadvantages of different imaging methods in GEP-NEN patient diagnosis.
| Heading | Sensitivity | Advantages | Disadvantages |
|---|---|---|---|
| US | PanNEN 13–27% 85–90% liver metastases (CEUS—99%) |
Cheap, widely accessible Can be enhanced by using contrast |
Not recommended for the other parts of the GI tract |
| EUS | PanNET 54–97% Insulinomas 71–94% |
Sensitivity of insulinoma detection higher than that achieved using CT (20–63%) Possibility of fine needle biopsy of the lesion |
The quality of the test depends greatly on the skill of the person performing the test Possibility of mistaking high-grade NENs for adenocarcinoma |
| CT contrast enhanced | PanNET 63–82% Metastases to the liver 82%, lymph nodes 60–70%, bones 58% |
Good visualization of vascular infiltration | Low sensitivity for detecting lesions < 1 cm and small lesions in duodenum, stomach and small intestine and bone metastases |
| MRI contrast enhanced | PanNEN 79% | Less radiation to the patient than that in CT | Low sensitivity for detecting small lesions in the duodenum, stomach and small intestine |
| DWI | 83% liver metastases | Detection of lesions after treatment Easier differentiation of hepatic NEN metastases from hemangiomas Measures the effectiveness of PRRT |
|
| 111In-pentetreotide SPECT/CT | PanNET 60–80% 90–100% liver metastases |
Better sensitivity than standard methods | More radiation Less effective than 68Ga-DOTA |
| 68Ga-DOTA-SSA PET/CT | PanNETs 79.6% 95–100% liver metastases (DOTATAC) |
Less radiation to the patient The most effective method listed |
Low half-life time—68 min |
CEUS: contrast-enhanced US; DWI: diffusion-weighted imaging; EUS: endoscopic US; GI: gastrointestinal; NEN: neuroendocrine neoplasm; PanNET: pancreatic neuroendocrine tumor; PanNEN: pancreatic neuroendocrine neoplasm; PRRT: peptide receptor radionuclide therapy; SSA: somatostatin analogs.