Franchellucci Gianluca, Andreozzi Marta, Carrara Silvia, De Luca Luca, Auriemma Francesco, Paduano Danilo, Calabrese Federica, Facciorusso Antonio, Poletti Valeria, Zerbi Alessandro, Lania Andrea Gerardo, Bertuzzi Alexia Francesca, Spaggiari Paola, Pedicini Vittorio, Rodari Marcello, Fusaroli Pietro, Lisotti Andrea, Ofosu Andrew, Repici Alessandro, Mangiavillano Benedetto
Gastrointestinal Endoscopy Unit, Humanitas Mater Domini, 21053 Castellanza, Italy.
Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy.
Diagnostics (Basel). 2023 Jan 9;13(2):239. doi: 10.3390/diagnostics13020239.
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.
胰腺神经内分泌肿瘤（PNET）的行为评估对医生来说是一项日常挑战。现代PNET的治疗方法因肿瘤侵袭性而异，从观察等待策略到手术治疗。因此，侵袭性的定义在PNET的检查过程中起着关键作用。PNET的侵袭性主要基于肿瘤大小和组织学分级，但其特异性和敏感性有时不足。在过去二十年中，超声内镜（EUS）因其高诊断率和获取组织学标本的可能性，已成为PNET治疗诊断阶段的基石。随着新的强大功能的出现，EUS在PNET检查中的应用数量迅速增加。造影剂的应用在PNET检测方面迈出了重要一步；近年来，它在侵袭性评估中也得到了有趣的应用。在这篇综述中，我们强调了使用接触增强EUS和有争议的增强谐波EUS对PNET进行行为评估的最新经验和机会，特别关注这些技术未来的应用和可能性。
