Recent developments in the diagnosis of pancreatic neuroendocrine neoplasms

ABSTRACT

Introduction

Pancreatic Neuroendocrine Neoplasms (PanNENs) are characterized by a highly heterogeneous clinical and biological behavior, making their diagnosis challenging. PanNENs diagnostic work-up mainly relies on biochemical markers, pathological examination, and imaging evaluation. The latter includes radiological imaging (i.e. computed tomography [CT] and magnetic resonance imaging [MRI]), functional imaging (i.e. 68Gallium [68 Ga]Ga-DOTA-peptide PET/CT and Fluorine-18 fluorodeoxyglucose [18F]FDG PET/CT), and endoscopic ultrasound (EUS) with its associated procedures.

Areas covered

This review provides a comprehensive assessment of the recent advancements in the PanNENs diagnostic field. PubMed and Embase databases were used for the research, performed from inception to October 2023.

Expert opinion

A deeper understanding of PanNENs biology, recent technological improvements in imaging modalities, as well as progresses achieved in molecular and cytological assays, are fundamental players for the achievement of early diagnosis and enhanced preoperative characterization of PanNENs. A multimodal diagnostic approach is required for a thorough disease assessment.

KEYWORDS:

• PanNENs
• diagnostic work-up
• biomarkers
• radiomics
• molecular signatures
• CE-EUS
• EUS-E
• [68Ga]Ga-DOTA-peptide PET
• [18F]FDG PET
• NETest

Article highlights

• PanNENs are characterized by a highly heterogeneous biological behavior, and a delayed diagnosis is frequently observed.

• Diagnostic modalities advances have allowed an early and accurate PanNENs identification.

• Significant progress has been made in the noninvasive preoperative characterization of PanNENs.

• A multimodal diagnostic approach is recommended for a comprehensive PanNENs evaluation.

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.