Imaging tests

Imaging plays an important role in detecting the primary tumor, identifying sites where there are metastases, examining suitability for surgery, choosing treatment, and assessing symptoms.

 

Anatomical imaging

Anatomical imaging is used to characterize different structures in the body, by distinguishing between different characteristics of the tissues/organs. For example, bone versus fat, hollowness with air versus soft tissue, tissue rich in blood vessels versus those that are poor in blood vessels, and the like.

 

CT

CT is usually the first imaging performed when a neuroendocrine tumor is suspected. This imaging is suitable for the diagnosis and follow-up of tumors in the neck, chest, abdomen, and pelvis.

 

MRI

An MRI scan is suitable for diagnosing and following tumors in the liver, pancreas, brain and bone. MRI has a higher sensitivity than CT to metastatic liver disease, an organ often involved in generalized neuroendocrine tumors.

 

Functional imaging

Functional imaging allows the characterization of tissues based on molecular and metabolic properties (metabolism) of cells in the body.

 

Ga-DOTATATE PET-CT

Neuroendocrine tumors express receptors for the hormone somatostatin. This feature allows the use of PET-CT imaging based on somatostatin analogs (similar substances) to which a radioactive substance (68Galium-DOTATATE) is bound. Photographing of the radioactive material in PET allows for accurate, specific and sensitive imaging for the diagnosis of neuroendocrine tumors, especially those with a high degree of differentiation.

 

F-FDG PET-CT

Cells that divide quickly consume more glucose than other organs. Therefore, injection of labeled glucose allows the identification of areas of active division, a characteristic of aggressive tumors. This test is used mainly in cases where the tumor has a medium-low degree of differentiation (i.e., medium-high aggressiveness).

 

Dual-tracer PET-CT

An imaging method that combines the two methods mentioned above.