Current update on imaging for pancreatic neuroendocrine neoplasms

Table 2 Imaging features of grade 3 pancreatic neuroendocrine tumors vs grade 3 pancreatic neuroendocrine carcinomas

Grade 3 PanNET	Grade 3 PanNEC
Smaller, more defined lesions	Larger, ill-defined lesions
Absence of ductal dilation or metastatic disease	Ductal dilation or metastatic disease
Low to moderate homogeneous enhancement on arterial phase imaging	Heterogeneous or rim-like enhancement on arterial phase imaging
Hypointense on delayed phase imaging	Atypical persistence of enhancement on delayed phase imaging
Higher ADC values	Signal hyperintensity on diffusion-weighted MRI and lower ADC value
Low uptake on 18F-FDG PET/CT	High uptake on 18F-FDG PET/CT
Moderate uptake on 68Ga-DOTATATE PET/CT	Low uptake on 68Ga-DOTATATE PET/CT

MRI: Magnetic resonance imaging; ADC: Apparent diffusion coefficient; PanNET: Pancreatic neuroendocrine tumors; PanNEC: Pancreatic neuroendocrine carcinomas; ADC: Apparent diffusion coefficient; ¹⁸F-FDG: Fluorine-18 fluorodeoxyglucose; PET/CT: positron emission tomography/computed tomography; ⁶⁸Ga-DOTATATE: Gallium-68 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid–octreotate.