Special Issue Information

Dear Colleagues,

Neuroendocrine tumors (NETs) are a group of rare and heterogeneous neoplasms with a variegated site of origin (even though they are located in the gastro-entero-pancreatic (GEP) sites in about 60% of cases and in the lung in approximately 30% of cases), but their incidence has risen in the last few decades partly due to advances in early detection and localization with the current imaging modalities, both morphological and functional. NETs are characterized by the peculiar and frequent expression on cell surfaces of somatostatin receptors, which represents the ideal target for molecular imaging and therapy (i.e., somatostatin analogues (SSAs) radiotracers and peptide-receptor radionuclide therapy (PRRT)).

Despite the development of radiologic imaging, the detection and follow-up of NETs still pose a diagnostic challenge due to the heterogeneity of NETs, their relatively long-term growth, and small size of the primary tumor. Regardless of imaging modality, dynamic contrast-enhanced imaging is essential for evaluation of NETs. In general, CT scan is typically the primary imaging modality for evaluating NETs. MRI is used as a complementary modality, being superior to other modalities to assess liver metastasis.

Nuclear medicine imaging is also widely used in NET assessment, especially after the advent of radioligand therapy, e.g., PRRT, to evaluate its feasibility and the subsequent response to therapy.

This Special Issue will focus on research papers, perspectives, and reviews informing readers about the role of current imaging modalities, both morphological and functional, in the evaluation of neuroendocrine tumors from characterization to assessment of treatment response and detection of early recurrence.

Dr. Priscilla Guglielmo
Guest Editor

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Keywords

NET
neuroendocrine tumors
CT
MRI
PET
molecular imaging
radiology
interventional radiology

Published Papers (2 papers)

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Review

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Open AccessReview

Diagnostic Management of Gastroenteropancreatic Neuroendocrine Neoplasms: Technique Optimization and Tips and Tricks for Radiologists

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Tomography 2023, 9(1), 217-246; https://doi.org/10.3390/tomography9010018 - 27 Jan 2023

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Abstract

Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) comprise a heterogeneous group of neoplasms, which derive from cells of the diffuse neuroendocrine system that specializes in producing hormones and neuropeptides and arise in most cases sporadically and, to a lesser extent, in the context of complex genetic syndromes. Furthermore, they are primarily nonfunctioning, while, in the case of insulinomas, gastrinomas, glucagonomas, vipomas, and somatostatinomas, they produce hormones responsible for clinical syndromes. The GEP-NEN tumor grade and cell differentiation may result in different clinical behaviors and prognoses, with grade one (G1) and grade two (G2) neuroendocrine tumors showing a more favorable outcome than grade three (G3) NET and neuroendocrine carcinoma. Two critical issues should be considered in the NEN diagnostic workup: first, the need to identify the presence of the tumor, and, second, to define the primary site and evaluate regional and distant metastases. Indeed, the primary site, stage, grade, and function are prognostic factors that the radiologist should evaluate to guide prognosis and management. The correct diagnostic management of the patient includes a combination of morphological and functional evaluations. Concerning morphological evaluations, according to the consensus guidelines of the European Neuroendocrine Tumor Society (ENETS), computed tomography (CT) with a contrast medium is recommended. Contrast-enhanced magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI), is usually indicated for use to evaluate the liver, pancreas, brain, and bones. Ultrasonography (US) is often helpful in the initial diagnosis of liver metastases, and contrast-enhanced ultrasound (CEUS) can solve problems in characterizing the liver, as this tool can guide the biopsy of liver lesions. In addition, intraoperative ultrasound is an effective tool during surgical procedures. Positron emission tomography (PET-CT) with FDG for nonfunctioning lesions and somatostatin analogs for functional lesions are very useful for identifying and evaluating metabolic receptors. The detection of heterogeneity in somatostatin receptor (SSTR) expression is also crucial for treatment decision making. In this narrative review, we have described the role of morphological and functional imaging tools in the assessment of GEP-NENs according to current major guidelines. Full article

(This article belongs to the Special Issue Diagnostic and Interventional Radiology in Neuroendocrine Tumor)

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Open AccessSystematic Review

Initial CT Imaging Predicts Mortality in Severe Traumatic Brain Injuries in Pediatric Population—A Systematic Review and Meta-Analysis

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Tomography 2023, 9(2), 541-551; https://doi.org/10.3390/tomography9020044 - 27 Feb 2023

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Abstract

The purpose of this systematic review was to analyze evidence based on existing studies on the ability of initial CT imaging to predict mortality in severe traumatic brain injuries (TBIs) in pediatric patients. An experienced librarian searched for all existing studies based on the inclusion and exclusion criteria. The studies were screened by two blinded reviewers. Of the 3277 studies included in the search, data on prevalence of imaging findings and mortality rate could only be extracted from 22 studies. A few of those studies had patient-specific data relating specific imaging findings to outcome, allowing the data analysis, calculation of the area under the curve (AUC) and receiver operating characteristic (ROC), and generation of a forest plot for each finding. The data were extracted to calculate the sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predicted value (NPV), AUC, and ROC for extradural hematoma (EDH), subdural hematoma (SDH), traumatic subarachnoid hemorrhage (tSAH), skull fractures, and edema. There were a total of 2219 patients, 747 females and 1461 males. Of the total, 564 patients died and 1651 survived; 293 patients had SDH, 76 had EDH, 347 had tSAH, 244 had skull fractures, and 416 had edema. The studies included had high bias and lower grade of evidence. Out of the different CT scan findings, brain edema had the highest SN, PPV, NPV, and AUC. EDH had the highest SP to predict in-hospital mortality. Full article

(This article belongs to the Special Issue Diagnostic and Interventional Radiology in Neuroendocrine Tumor)

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The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

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