Current update on imaging for pancreatic neuroendocrine neoplasms

doi:10.5306/wjco.v12.i10.897

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World Journal of Clinical Oncology

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2218-4333

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World J Clin Oncol. Oct 24, 2021; 12(10): 897-911
Published online Oct 24, 2021. doi: 10.5306/wjco.v12.i10.897

Table 1 Comparison of 2010 and 2017 World Health Organization classification system for pancreatic neuroendocrine tumors

WHO 2010 Classification system	WHO 2017 Classification system	Ki-67 index (%)	Mitotic index¹
Well-differentiated PanNET G1	Well-differentiated PanNET G1	< 3	< 2
Well-differentiated PanNET G2	Well-differentiated PanNET G2	3-20	2-20
	Well-differentiated PanNET G3	> 20	> 20
Poorly-differentiated PanNEC G3 (i.e. small cell carcinoma, large cell carcinoma)	Poorly-differentiated PanNEC G3 (i.e. small cell carcinoma, large cell carcinoma)	> 20	> 20
MiNEN	MANEC

¹Per 10 high-power fields. WHO: World Health Organization; PanNEN: Pancreatic neuroendocrine neoplasms; PanNET: Pancreatic neuroendocrine tumors; PanNEC: Pancreatic neuroendocrine carcinomas; MiNEN: mixed neuroendocrine-nonneuroendocrine neoplasms; MANEC: Mixed adenoneuroendocrine carcinomas.

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.

Citation: Segaran N, Devine C, Wang M, Ganeshan D. Current update on imaging for pancreatic neuroendocrine neoplasms. World J Clin Oncol 2021; 12(10): 897-911
URL: https://www.wjgnet.com/2218-4333/full/v12/i10/897.htm
DOI: https://dx.doi.org/10.5306/wjco.v12.i10.897