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ESMO 2025 | Imaging techniques to identify PanNETs at higher risk of progression
Stefano Partelli, MD, Vita-Salute San Raffaele University, Milan, Italy, discusses the importance of imaging modalities in monitoring patients with pancreatic neuroendocrine tumors (PanNETs), highlighting that MRI is the preferred choice due to the need for repeated imaging during follow-up to avoid exposure to X-rays. Dilatation of the main pancreatic duct and tumor growth, particularly when the tumor reaches two centimeters or above, are key warning signs at which point surgery is recommended. This interview took place at the European Society for Medical Oncology (ESMO) 2025 Congress in Berlin, Germany.
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Transcript
Well, I would say that considering the results of the study now, we can say that for all the patients with asymptomatic small pancreatic net, active surveillance should be considered first. With some exceptions, we know that there are a few patients who have a specific sign of aggressiveness. One specific sign is the dilatation of the main pancreatic duct. So in these cases, again, there are very rare cases, we should perform surgery because of a more aggressive behavior of the tumor...
Well, I would say that considering the results of the study now, we can say that for all the patients with asymptomatic small pancreatic net, active surveillance should be considered first. With some exceptions, we know that there are a few patients who have a specific sign of aggressiveness. One specific sign is the dilatation of the main pancreatic duct. So in these cases, again, there are very rare cases, we should perform surgery because of a more aggressive behavior of the tumor. In all the other cases, active surveillance is a safe approach. The protocol that was employed for the ASPEN study demonstrated to be safe in detecting early progression of the nodule and so it allowed to intervene in a timely manner.
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