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Updated: Jul 11, 2025

Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head
Published on: January 3, 2020
[Neuroendocrine tumors of the pancreas]
Markus Juchems1, Benjamin Kläsner2
1Zentrum für Diagnostische und Interventionelle Radiologie im GLKN, Klinikum Konstanz, 78464, Konstanz, Deutschland. markus.juchems@glkn.de.
Clinical/Methodological Issue:
Neuroendocrine tumors (NET) of the pancreas fall into the group of gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN). The assignment of imaging morphological criteria to this heterogeneous group of complex tumors is often difficult.
Standard Radiological Methods:
Diagnostic ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography-CT (PET/CT) are available for the detection of pancreatic NET (also referred to as NEN) and for the diagnosis of spread and the search for metastases.
Methodological Innovations:
In particular, nuclear medicine examination methods with somatostatin analogues are of high value, since they make tumors visible with high sensitivity via radioactively labeled receptor ligands.
Performance:
CT and MRI have high detection rates of pancreatic NET. Further developments, such as diffusion imaging, have further improved these traditional cross-sectional imaging diagnostics. However, nuclear medicine methods are an important component in detection and are superior to CT and MRI.
Achievements:
It is important for the radiologist to be familiar with NET of the pancreas, as it is an important differential diagnosis-also with regard to prognosis-of other pancreatic lesions.
Practical Recommendations:
Because NET are often hypervascularized, a biphasic examination technique after contrast administration is mandatory for cross-sectional imaging. PET/CT with somatostatin analogues should be performed for further diagnosis.
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