Pancreatic Neuroendocrine Diagnostic Imaging Order and Reader Evaluation over Two Decades in a Tertiary Academic Center

TL;DR

This study examines how imaging techniques for diagnosing pancreatic neuroendocrine tumors have evolved over two decades in a major hospital.

Contribution

The study identifies a shift in imaging trends for pNETs and highlights the role of CT and MRI in diagnosis and staging.

Findings

CT scans remained the primary initial imaging method for pNETs due to their availability and resolution.

MRI usage increased, particularly for syndromic patients, due to its precision for follow-up and surgery planning.

Abstract

Background/Objective: Identifying patterns of diagnostic imaging workflow parallel to the influence of certain variables, such as pathology guidelines over time, provides valuable insight for clinical decision making. This study presents a recurring trend of initial imaging orders and follow-ups, up to the diagnosis of pancreatic neuroendocrine tumors (pNETs), across two decades, with scans which led to pathological investigation. Methods: Three readers evaluated common conventional imaging among initial and follow-up studies for lesion detection and localization. Inter-reader and intra-reader analyses were controlled as contributing factors to the imaging diagnostic trend. Results: Our results show that CT was the prominent initial scan in pNET workup, likely due to their wide availability, high spatial resolution, and rapid acquisition, with a sufficient detection rate throughout both decades, regardless of technical advances. However, MRI scans also gained soaring popularity, especially among syndromic patients, likely due to follow-up and anatomical surgery precision. Conclusions: Newer modalities may be eventually useful and only requested for pNETs staging and further treatment.

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