Diagnostics (Jan 2023)

Contrast Enhanced EUS for Predicting Solid Pancreatic Neuroendocrine Tumor Grade and Aggressiveness

  • Gianluca Franchellucci,
  • Marta Andreozzi,
  • Silvia Carrara,
  • Luca De Luca,
  • Francesco Auriemma,
  • Danilo Paduano,
  • Federica Calabrese,
  • Antonio Facciorusso,
  • Valeria Poletti,
  • Alessandro Zerbi,
  • Andrea Gerardo Lania,
  • Alexia Francesca Bertuzzi,
  • Paola Spaggiari,
  • Vittorio Pedicini,
  • Marcello Rodari,
  • Pietro Fusaroli,
  • Andrea Lisotti,
  • Andrew Ofosu,
  • Alessandro Repici,
  • Benedetto Mangiavillano

DOI
https://doi.org/10.3390/diagnostics13020239
Journal volume & issue
Vol. 13, no. 2
p. 239

Abstract

Read online

Pancreatic neuroendocrine tumor (PNET) behavior assessment is a daily challenge for physicians. Modern PNET management varies from a watch-and-wait strategy to surgery depending on tumor aggressiveness. Therefore, the aggressiveness definition plays a pivotal role in the PNET work-up. The aggressiveness of PNETs is mainly based on the dimensions and histological grading, with sometimes a lack of specificity and sensibility. In the last twenty years, EUS has become a cornerstone in the diagnostic phase of PNET management for its high diagnostic yield and the possibility of obtaining a histological specimen. The number of EUS applications in the PNET work-up has been rapidly increasing with new and powerful possibilities. The application of contrast has led to an important step in PNET detection; in recent years, it has been gaining interesting applications in aggressiveness assessment. In this review, we underline the latest experiences and opportunities in the behavior assessment of PNETs using contact-enhanced EUS and contested enhanced harmonic EUS with a particular focus on the future application and possibility that these techniques could provide.

Keywords