American Board of Internal Medicine (ABIM) Certification Practice Exam

What imaging modalities are preferred for managing well-differentiated neuroendocrine tumors?

1. Ultrasound and X-ray

2. Triple-phase contrast-enhanced CT scanning or MRI with gadolinium

3. CT scan alone

4. Plain film radiography

The correct answer is: Triple-phase contrast-enhanced CT scanning or MRI with gadolinium

The preferred imaging modalities for managing well-differentiated neuroendocrine tumors are triple-phase contrast-enhanced CT scanning or MRI with gadolinium. These imaging techniques provide detailed information about the tumor's size, location, and vascularity, which are essential for both diagnosis and treatment planning. Triple-phase contrast-enhanced CT scanning is especially useful for visualizing the vascular supply of neuroendocrine tumors, which can help assess their extent, presence of metastases, and involvement of surrounding structures. The three phases correspond to different times post-contrast injection, allowing clinicians to see how the tumor interacts with blood flow. This can aid in differentiating well-differentiated tumors from other types and understanding their functional status. MRI with gadolinium also enhances the visualization of soft tissue structures and provides excellent contrast resolution, making it another valuable tool in the evaluation of neuroendocrine tumors. Gadolinium enhances the contrast between the tumor and surrounding tissues, further improving diagnostic accuracy. In contrast, options such as ultrasound and X-ray are generally less effective for detecting these tumors or providing the comprehensive assessment that is often required in clinical practice. Plain film radiography offers limited information regarding soft tissue masses or complex anatomical relationships. Therefore, the use of