Gastric neuroendocrine neoplasms: a primer for radiologists.

Molly E Roseland, Isaac R Francis, Kimberly L Shampain, Erica B Stein, Ashish P Wasnik, John D Millet

Abdominal radiology (New York) 2022 Dec

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Gastric neuroendocrine neoplasms are uncommon tumors with variable differentiation and malignant potential. Three main subtypes are recognized: type 1, related to autoimmune atrophic gastritis; type 2, associated with Zollinger-Ellison and MEN1 syndrome; and type 3, sporadic. Although endoscopy alone is often sufficient for diagnosis and management of small, indolent, multifocal type 1 tumors, imaging is essential for evaluation of larger, high-grade, and type 2 and 3 neoplasms. Hypervascular intraluminal gastric masses are typically seen on CT/MRI, with associated perigastric lymphadenopathy and liver metastases in advanced cases. Somatostatin receptor nuclear imaging (such as Ga-68-DOTATATE PET/CT) may also be used for staging and assessing candidacy for peptide receptor radionuclide therapy. Radiotracer uptake is more likely in well-differentiated, lower-grade tumors, and less likely in poorly differentiated tumors, for which F-18-FDG-PET/CT may have additional value. Understanding disease pathophysiology and evolving histologic classifications is particularly useful for radiologists, as these influence tumor behavior, preferred imaging, therapy options, and patient prognosis. © 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Citation

Molly E Roseland, Isaac R Francis, Kimberly L Shampain, Erica B Stein, Ashish P Wasnik, John D Millet. Gastric neuroendocrine neoplasms: a primer for radiologists. Abdominal radiology (New York). 2022 Dec;47(12):3993-4004