Modern sonographic imaging of abdominal neuroendocrine tumors

Background. Radiological and nuclear medical diagnostics play an important role in the work-up of patients with gastroenteropancreatic neuroendocrine tumors (GEP-NET). The sonographic examination, including contrast-enhanced examination, depicts an initial imaging modality to screen for NET. This report describes the sonomorphological behavior of ileal and pancreatic NET as well as hepatic metastases from NET. Clinical/methodical issue. Sonographic evaluation of NET of the small intestine, pancreas and neuroendocrine hepatic metastases. Standard radiological methods. Contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI), unenhanced ultrasonography. Methodical innovations. Contrast-enhanced ultrasound (CEUS). Performance. CEUS supports unenhanced ultrasound in the detection of NET and the differential diagnosis of unclear lesions, and is more sensitive for liver metastases (sensitivity according to the literature, 99% vs. 68%) Practical recommendations. CEUS allows initial evaluation of NET and differentiation of benign vs. malignant lesions. Nevertheless, CEUS cannot replace more elaborate imaging modalities like CT or MRI for thorough staging examinations.