The diagnostic tests that are used are determined by several factors, including the type of neuroendocrine tumor suspected, the signs and symptoms you’re experiencing, your age and general health and the results of previous medical tests. If a neuroendocrine tumor is detected, our care team will utilize a combination of tests to determine if the cancer has spread to other parts of the body.

Biopsy

A biopsy is the removal of sample tissue, cells, fluids or growths which is examined by a pathologist under a microscope to determine if neuroendocrine tumors are present. If a pheochromocytoma, a rare subset of neuroendocrine tumor of the adrenal glands, is suspected, a biopsy will not be used unless absolutely necessary. A biopsy can be dangerous and potentially life-threatening in these rare cases.

Blood and urine tests

Blood and urine tests look for excess hormones and other substances. Certain neuroendocrine tumors produce a neurotransmitter called serotonin, a chemical messenger that transmits messages to nerve cells and occurs naturally in the body. As serotonin breaks down, it produces a byproduct called 5-HIAA. Urine tests are used to detect excess amounts of 5-HIAA. Serotonin levels may also be checked via blood test.

Endoscopy

An endoscopy is a procedure that looks for diseases inside the body and organs using a long, thin and flexible tube, called an endoscope. The type of endoscopy performed depends on the suspected location of a tumor within the body. A bronchoscopy examines the lungs, an upper endoscopy examines the stomach and esophagus and a colonoscopy examines the rectum and colon.

Molecular testing

Also known as biomarker testing of the tumor, molecular testing uses laboratory tests to identify unique attributes of your tumor, including genes, proteins and other factors. Molecular testing can sometimes be helpful in determining your treatment options.

Imaging tests

Certain imaging tests are used to diagnose neuroendocrine tumors, as well as determine the tumor size and location:

• Computed tomography (CT) scans: This imaging test uses x-rays to take pictures of the inside of your body from different angles and produce detailed 3-dimensional images.
• Magnetic resonance imaging (MRI) scans: These imaging tests use radio waves and strong magnets to show detailed images of soft tissues in the body. Gadolinium, a contrast agent dye, may be injected into the vein prior to conducting the MRI scan to view scans with more detail.
• Nuclear medicine imaging: This imaging test injects a small radioactive tracer into your vein, then uses a PET-CT scan to view where the radioactivity has accumulated in the body.
• Ultrasounds: These imaging tests use sound waves to create a picture of your body’s organs. Tumors produce different echoes of the sound waves than normal tissue and can create an image of a mass inside the body. Different ultrasounds are used for different parts of the body and in some cases, a biopsy is done at the same time as the ultrasound.

The tests that are used will not only help detect if a neuroendocrine tumor is present, but will also help determine the tumor’s stage, grade, where the tumor is located and the extent of the tumor’s growth or spread to other parts of the body. Knowing the tumor’s grade will help inform your treatment plan and prognosis.

The dedicated and supportive health care specialists at Banner Health are here by your side to ensure you receive some of the most advanced diagnostic testing and the best quality of care.