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Erschienen in: CardioVascular and Interventional Radiology 4/2018

22.11.2017 | Clinical Investigation

The Value of Hybrid Angio-CT in Preoperative Detection and Localization of Insulinomas: A Single-Center Retrospective Study

verfasst von: Jinxin Fu, Fengyong Liu, Kai Yuan, Jieyu Yan, Yan Wang, Jinlong Zhang, Bing Yuan, Maoqiang Wang

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 4/2018

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Abstract

Objective

To investigate the performance of hybrid angio-CT in preoperative detection and localization for insulinomas.

Methods

Fifty-four postoperative pathology-confirmed patients from April 2015 to March 2017 were retrospectively reviewed; all patients underwent angio-CT with administration of contrast media in SMA, GDA and SA due to negative, inconclusive or controversial findings by several preoperative diagnostic methods including TAUS, CEUS, EUS, ECT, EMRI and DSA. Surgery was used as gold standard for localization of insulinomas; detection sensitivity and localization accuracy of angio-CT were assessed and compared with other preoperative image options.

Results

Fifty-six benign insulinomas (mean diameter, 15.8 mm) in 54 patients (18 men and 36 women) were found according to surgical results; the overall detection sensitivity of TAUS, CEUS, EUS, ECT, EMRI and DSA was 21.4, 78.4, 79.2, 70.0, 79.2 and 72.2%, respectively. The overall localization accuracy was 14.3, 58.8, 68.8, 60.0, 75.0 and 44.4%, respectively. A total of 53 tumors were detected by angio-CT, 51 tumors were accurately located, and the overall detection sensitivity and localization accuracy of angio-CT was 94.4 and 90.7%, which was significantly higher than that of all other preoperative diagnostic methods (p < 0.05). No any serious complications occurred during angio-CT.

Conclusion

Our study indicates the great potential value of angio-CT in the preoperative detection and localization of insulinomas; angio-CT can be used as a preferred invasive diagnostic method.
Literatur
1.
Zurück zum Zitat Service FJ, McMahon MM, O’Brien PC, Ballard DJ. Functioning insulinoma–incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo Clin Proc. 1991;66(7):711–9.CrossRefPubMed Service FJ, McMahon MM, O’Brien PC, Ballard DJ. Functioning insulinoma–incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo Clin Proc. 1991;66(7):711–9.CrossRefPubMed
2.
Zurück zum Zitat Halfdanarson TR, Rabe KG, Rubin J, Petersen GM. Pancreatic neuroendocrine tumors (PNETs): incidence, prognosis and recent trend toward improved survival. Ann Oncol Off J Eur Soc Med Oncol. 2008;19(10):1727–33.CrossRef Halfdanarson TR, Rabe KG, Rubin J, Petersen GM. Pancreatic neuroendocrine tumors (PNETs): incidence, prognosis and recent trend toward improved survival. Ann Oncol Off J Eur Soc Med Oncol. 2008;19(10):1727–33.CrossRef
3.
Zurück zum Zitat Doi R, Komoto I, Nakamura Y, et al. Pancreatic endocrine tumor in Japan. Pancreas. 2004;28(3):247–52.CrossRefPubMed Doi R, Komoto I, Nakamura Y, et al. Pancreatic endocrine tumor in Japan. Pancreas. 2004;28(3):247–52.CrossRefPubMed
4.
Zurück zum Zitat Daggett PR, Goodburn EA, Kurtz AB, et al. Is preoperative localisation of insulinomas necessary? Lancet. 1981;1(8218):483–6.CrossRefPubMed Daggett PR, Goodburn EA, Kurtz AB, et al. Is preoperative localisation of insulinomas necessary? Lancet. 1981;1(8218):483–6.CrossRefPubMed
6.
Zurück zum Zitat Coelho C, Druce MR, Grossman AB. Diagnosis of insulinoma in a patient with hypoglycemia without obvious hyperinsulinemia. Nature reviews. Endocrinology. 2009;5(11):628–31.PubMed Coelho C, Druce MR, Grossman AB. Diagnosis of insulinoma in a patient with hypoglycemia without obvious hyperinsulinemia. Nature reviews. Endocrinology. 2009;5(11):628–31.PubMed
7.
Zurück zum Zitat Assalia A, Gagner M. Laparoscopic pancreatic surgery for islet cell tumors of the pancreas. World J Surg. 2004;28(12):1239–47.CrossRefPubMed Assalia A, Gagner M. Laparoscopic pancreatic surgery for islet cell tumors of the pancreas. World J Surg. 2004;28(12):1239–47.CrossRefPubMed
8.
Zurück zum Zitat Giudici F, Nesi G, Brandi ML, Tonelli F. Surgical management of insulinomas in multiple endocrine neoplasia type 1. Pancreas. 2012;41(4):547–53.CrossRefPubMed Giudici F, Nesi G, Brandi ML, Tonelli F. Surgical management of insulinomas in multiple endocrine neoplasia type 1. Pancreas. 2012;41(4):547–53.CrossRefPubMed
9.
Zurück zum Zitat Goh BK, Ooi LL, Cheow PC, et al. Accurate preoperative localization of insulinomas avoids the need for blind resection and reoperation: analysis of a single institution experience with 17 surgically treated tumors over 19 years. J Gastrointest Surg. 2009;13(6):1071–7.CrossRefPubMed Goh BK, Ooi LL, Cheow PC, et al. Accurate preoperative localization of insulinomas avoids the need for blind resection and reoperation: analysis of a single institution experience with 17 surgically treated tumors over 19 years. J Gastrointest Surg. 2009;13(6):1071–7.CrossRefPubMed
10.
Zurück zum Zitat Varma V, Tariciotti L, Coldham C, Taniere P, Buckels JA, Bramhall SR. Preoperative localisation and surgical management of insulinoma: single centre experience. Dig Surg. 2011;28(1):63–73.CrossRefPubMed Varma V, Tariciotti L, Coldham C, Taniere P, Buckels JA, Bramhall SR. Preoperative localisation and surgical management of insulinoma: single centre experience. Dig Surg. 2011;28(1):63–73.CrossRefPubMed
11.
Zurück zum Zitat Takeshita K, Kutomi K, Takada K, Kohtake H, Furui S. 3D pancreatic arteriography with MDCT during intraarterial infusion of contrast material in the detection and localization of insulinomas. AJR Am J Roentgenol. 2005;184(3):852–4.CrossRefPubMed Takeshita K, Kutomi K, Takada K, Kohtake H, Furui S. 3D pancreatic arteriography with MDCT during intraarterial infusion of contrast material in the detection and localization of insulinomas. AJR Am J Roentgenol. 2005;184(3):852–4.CrossRefPubMed
12.
Zurück zum Zitat Li W, An L, Liu R, et al. Laparoscopic ultrasound enhances diagnosis and localization of insulinoma in pancreatic head and neck for laparoscopic surgery with satisfactory postsurgical outcomes. Ultrasound Med Biol. 2011;37(7):1017–23.CrossRefPubMed Li W, An L, Liu R, et al. Laparoscopic ultrasound enhances diagnosis and localization of insulinoma in pancreatic head and neck for laparoscopic surgery with satisfactory postsurgical outcomes. Ultrasound Med Biol. 2011;37(7):1017–23.CrossRefPubMed
13.
Zurück zum Zitat An L, Li W, Yao KC, et al. Assessment of contrast-enhanced ultrasonography in diagnosis and preoperative localization of insulinoma. Eur J Radiol. 2011;80(3):675–80.CrossRefPubMed An L, Li W, Yao KC, et al. Assessment of contrast-enhanced ultrasonography in diagnosis and preoperative localization of insulinoma. Eur J Radiol. 2011;80(3):675–80.CrossRefPubMed
14.
Zurück zum Zitat Zhao YP, Zhan HX, Zhang TP, et al. Surgical management of patients with insulinomas: result of 292 cases in a single institution. J Surg Oncol. 2011;103(2):169–74.CrossRefPubMed Zhao YP, Zhan HX, Zhang TP, et al. Surgical management of patients with insulinomas: result of 292 cases in a single institution. J Surg Oncol. 2011;103(2):169–74.CrossRefPubMed
15.
Zurück zum Zitat Jyotsna VP, Rangel N, Pal S, Seith A, Sahni P, Ammini AC. Insulinoma: diagnosis and surgical treatment. Retrospective analysis of 31 cases. Indian J Gastroenterol Off J Indian Soc Gastroenterol. 2006;25(5):244–7. Jyotsna VP, Rangel N, Pal S, Seith A, Sahni P, Ammini AC. Insulinoma: diagnosis and surgical treatment. Retrospective analysis of 31 cases. Indian J Gastroenterol Off J Indian Soc Gastroenterol. 2006;25(5):244–7.
16.
Zurück zum Zitat Gouya H, Vignaux O, Augui J, et al. CT, endoscopic sonography, and a combined protocol for preoperative evaluation of pancreatic insulinomas. AJR Am J Roentgenol. 2003;181(4):987–92.CrossRefPubMed Gouya H, Vignaux O, Augui J, et al. CT, endoscopic sonography, and a combined protocol for preoperative evaluation of pancreatic insulinomas. AJR Am J Roentgenol. 2003;181(4):987–92.CrossRefPubMed
17.
Zurück zum Zitat Zhu L, Xue H, Sun H, et al. Insulinoma detection with MDCT: is there a role for whole-pancreas perfusion? AJR Am J Roentgenol. 2017;208(2):306–14.CrossRefPubMed Zhu L, Xue H, Sun H, et al. Insulinoma detection with MDCT: is there a role for whole-pancreas perfusion? AJR Am J Roentgenol. 2017;208(2):306–14.CrossRefPubMed
18.
Zurück zum Zitat Zhu L, Xue H, Sun Z, et al. Prospective comparison of biphasic contrast-enhanced CT, volume perfusion CT, and 3 Tesla MRI with diffusion-weighted imaging for insulinoma detection. J Magn Reson Imaging. 2017;46(6):1648–1655.CrossRefPubMed Zhu L, Xue H, Sun Z, et al. Prospective comparison of biphasic contrast-enhanced CT, volume perfusion CT, and 3 Tesla MRI with diffusion-weighted imaging for insulinoma detection. J Magn Reson Imaging. 2017;46(6):1648–1655.CrossRefPubMed
19.
Zurück zum Zitat Mehrabi A, Fischer L, Hafezi M, et al. A systematic review of localization, surgical treatment options, and outcome of insulinoma. Pancreas. 2014;43(5):675–86.CrossRefPubMed Mehrabi A, Fischer L, Hafezi M, et al. A systematic review of localization, surgical treatment options, and outcome of insulinoma. Pancreas. 2014;43(5):675–86.CrossRefPubMed
20.
Zurück zum Zitat Sotoudehmanesh R, Hedayat A, Shirazian N, et al. Endoscopic ultrasonography (EUS) in the localization of insulinoma. Endocrine. 2007;31(3):238–41.CrossRefPubMed Sotoudehmanesh R, Hedayat A, Shirazian N, et al. Endoscopic ultrasonography (EUS) in the localization of insulinoma. Endocrine. 2007;31(3):238–41.CrossRefPubMed
21.
Zurück zum Zitat Shin JJ, Gorden P, Libutti SK. Insulinoma: pathophysiology, localization and management. Future Oncol (Lond, Engl). 2010;6(2):229–37.CrossRef Shin JJ, Gorden P, Libutti SK. Insulinoma: pathophysiology, localization and management. Future Oncol (Lond, Engl). 2010;6(2):229–37.CrossRef
22.
Zurück zum Zitat Mirallie E, Pattou F, Malvaux P, et al. Value of endoscopic ultrasonography and somatostatin receptor scintigraphy in the preoperative localization of insulinomas and gastrinomas. Experience of 54 cases. Gastroenterol Clin Biol. 2002;26(4):360–6.PubMed Mirallie E, Pattou F, Malvaux P, et al. Value of endoscopic ultrasonography and somatostatin receptor scintigraphy in the preoperative localization of insulinomas and gastrinomas. Experience of 54 cases. Gastroenterol Clin Biol. 2002;26(4):360–6.PubMed
23.
Zurück zum Zitat Geoghegan JG, Jackson JE, Lewis MP, et al. Localization and surgical management of insulinoma. Br J Surg. 1994;81(7):1025–8.CrossRefPubMed Geoghegan JG, Jackson JE, Lewis MP, et al. Localization and surgical management of insulinoma. Br J Surg. 1994;81(7):1025–8.CrossRefPubMed
Metadaten
Titel
The Value of Hybrid Angio-CT in Preoperative Detection and Localization of Insulinomas: A Single-Center Retrospective Study
verfasst von
Jinxin Fu
Fengyong Liu
Kai Yuan
Jieyu Yan
Yan Wang
Jinlong Zhang
Bing Yuan
Maoqiang Wang
Publikationsdatum
22.11.2017
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 4/2018
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-017-1847-2

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