3D Pancreatic Arteriography with MDCT During Intraarterial Infusion of Contrast Material in the Detection and Localization of Insulinomas

Arterial vs pancreatic phase: which is the best choice in the evaluation of pancreatic endocrine tumours with multidetector computed tomography (MDCT)?

“…The value of spiral computed tomography (SCT) in the evaluation of endocrine pancreatic tumours has already been reported [1][2][3][4][5][6][7][8]. SCT has variable sensitivity (47%-72%) [1][2][3] in the detection of endocrine pancreatic tumours, and this sensitivity significantly decreases in the evaluation of small (< 2 cm) lesions (12%) [2].…”

“…SCT has variable sensitivity (47%-72%) [1][2][3] in the detection of endocrine pancreatic tumours, and this sensitivity significantly decreases in the evaluation of small (< 2 cm) lesions (12%) [2]. There are only few reports about multidetector computed tomography (MDCT) in pancreatic endocrine tumours [4][5][6][7][8][9]. Most of them [4][5][6] have used 4-or 8-row CT scanners and analysed a limited number of lesions and mostly a specific subtype of endocrine tumours (insulinomas), or they have evaluated endocrine lesions together with pancreatic or periampullary tumours [7,8].…”

“…There are only few reports about multidetector computed tomography (MDCT) in pancreatic endocrine tumours [4][5][6][7][8][9]. Most of them [4][5][6] have used 4-or 8-row CT scanners and analysed a limited number of lesions and mostly a specific subtype of endocrine tumours (insulinomas), or they have evaluated endocrine lesions together with pancreatic or periampullary tumours [7,8]. The most recent paper on endocrine tumours is an education exhibit in which a 64-channel CT scanner was employed [9].…”

“…With MDCT, the reported biphasic technique consists of either an early or late arterial phase [4,14] followed by a portal phase [4]. Triple-phase acquisition (with arterial, pancreatic and portal phases) has been performed in a small number of patients [4,6]. It has been reported that the pancreatic phase may replace the arterial phase in insulinoma protocols, but further studies have been advocated to asses this issue [4].…”

Five Levels of PACS Modularity: Integrating 3D and Other Advanced Visualization Tools

“…Key clinical areas for such techniques include vascular applications (e.g., CT and MR angiography of the head and neck [1,2], of the trunk and extremities [3,4], as well as of the coronary arteries [5,6]), and CT colonography [7,8]. Three-dimensional evaluation through volumetric post-processing has also been described in a wide range of other clinical settings, including traumatic injury [9,10], tumor mapping [11,12], bronchial visualization [13,14], and urinary tract imaging [15]. Advancements in thin-slice multidetector CT, and the advent of high-resolution isotropic MRI, have only increased the opportunities and need for volumetric image post-processing in radiology.…”