The role of endoscopic ultrasound in diagnosing pancreatic neuroendocrine tumours

Pancreatic tumour imaging poses one of the greatest challenges in gastroenteropancreatic tumour diagnostics. Though much less common than adenocarcinomas, tumours deriving from pancreatic islets are the second most common group of pancreatic tumours. The manifestations and growth rate of neuroendocrine tumours (NETs) differ from adenocarcinomas; thus, these tumour types require different diagnostic and therapeutic approaches. With its high sensitivity and specificity, endoscopic ultrasound (EUS) seems to be indispensable in pancreatic NET diagnostics. A negative EUS practically excludes the presence of a pancreatic tumour, while in definitive tumour cases, EUS is helpful in tumour staging, and in determining its precise anatomical location. One especially important benefit of EUS is the option of performing a biopsy for subsequent cytological and histopathological examinations. The use of contrast and additional computerized image analysis increases the diagnostic accuracy of EUS. This article presents current views on the use of EUS in pancreatic tumour diagnostics, with a particular emphasis on diagnosing NETs.