What are the NCCN guidelines on the initial evaluation of neuroendocrine tumors (NETs)?

Updated: Dec 23, 2018
  • Author: Evan S Ong, MD, MS; more...
  • Print
Answer

Answer

For evaluation of duodenal, jejunal, ileal, and colonic neuroendocrine tumors (NETs), the National Comprehensive Cancer Network (NCCN) recommends abdominal/pelvic multiphasic CT or MRI and any of the following as appropriate [7] :

  • Somatostatin receptor scintigraphy
  • Colonoscopy
  • Small-bowel imaging (CT enterography or capsule endoscopy)
  • Chest CT
  • Biochemical evaluation if clinically indicated by symptoms of hormone secretion

For evaluation of T1 rectal NETs, the NCCN recommends endorectal MRI or endoscopic ultrasound (EUS); for T2-T4 rectal NETs, recommended studies are as follows:

  • Colonoscopy
  • Abdominal/pelvic multi-phasic CT or MRI
  • Endorectal MRI or EUS

In addition, the following are recommended to be done, as appropriate:

  • Somatostatin receptor scintigraphy
  • Chest CT
  • Biochemical evaluation if clinically indicated

For evaluation of gastric NETs, NCCN recommendations are as follows:

  • Esophagogastroduodenoscopy (EGD)
  • Gastric biopsy
  • Serum gastrin level
  • Consider gastric pH, as appropriate

For evaluation of bronchopulmonary NETs, the NCCN recommends chest CT and abdominal multiphasic CT or MRI, with the following as appropriate:

  • Somatostatin receptor scintigraphy
  • Bronchoscopy
  • Biochemical workup for Cushing syndrome, if clinically indicated
  • Other biochemical evaluation, as clinically indicated

For evaluation of thymus NETs, the NCCN recommends chest/mediastinal multiphasic CT and abdominal multiphasic CT or MRI, the following as appropriate:

  • Somatostatin receptor scintigraphy
  • Bronchoscopy
  • Biochemical workup for Cushing syndrome, if clinically indicated
  • Other biochemical evaluation, as clinically indicated

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!