Localization of the source of hyperinsulinism: percutaneous transhepatic portal and pancreatic vein catheterization with hormone assay

Cho, K. J.; Vinik, Aaron I.; Thompson, Norman W.; Shields, J. J.; Porter, David; Brady, TM; Cadavid, Gilberto; Fajans, Stefan S.

doi:10.2214/ajr.139.2.237

Cited by 48 publications

(25 citation statements)

References 5 publications

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“…Selective pancreatic venous sampling is the most specific technique for localizing endocrine tumors, with success rates of 87-94% for superselective catheterization and 62-67% for large-vein sampling [24][25][26][27]. Unlike other techniques, it permits tumor localization and also the diagnosis of diffuse microadenomatosis and hyperplasia of the islet cells [6,21,28].…”

Section: Discussionmentioning

confidence: 99%

Localization of small islet-cell tumors. Preoperative and intraoperative ultrasound, computed tomography, arteriography, digital subtraction angiography, and pancreatic venous sampling

Günther

Klose

Rückert

et al. 1985

Gastrointest Radiol

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A total of 42 islet-cell tumors were examined between 1972 and 1984. Problems of localization were only encountered in 31 tumors less than 2 cm in diameter. Of 31 small tumors, 27 were correctly localized using a combined diagnostic approach: ultrasound was successful in 12/20 tumors, CT in 9/21, angiography in 20/31, intraarterial digital subtraction angiography in 1/2, and pancreatic venous sampling in 13/16. The smallest tumor found by ultrasound and CT was 7 mm in diameter. Intraoperative ultrasound demonstrated all 9 insulinomas examined. Currently, the most useful techniques for localizing small islet-cell tumors are ultrasound, CT, and angiography. CT is particularly useful for tumor staging. Improvement of non-invasive diagnostic techniques will obviate the need for transhepatic blood sampling.

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Section: Discussionmentioning

confidence: 99%

Localization of small islet-cell tumors. Preoperative and intraoperative ultrasound, computed tomography, arteriography, digital subtraction angiography, and pancreatic venous sampling

Günther

Klose

Rückert

et al. 1985

Gastrointest Radiol

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“…Unfortunately, this amount of resection is associated with significant mortality and morbidity and a greater incidence of persistent hyperinsulinism, necessitating a second operation. 8 Angiography has been the modality most successful for preoperative localization, with reported accuracies of as much as approximately 90 per cent. Several authors emphasize the importance of using such techniques as subtraction studies and selective injection in achieving this level of accuracy.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative real-time ultrasonographic localization of pancreatic insulinoma: initial experience.

Charboneau¹,

James²,

Heerden³

et al. 1983

Journal of Ultrasound in Medicine

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“…As the blood is directly taken from the possible peripancreatic tumor draining veins even small amounts of secreted hormone can be detected as the liver metabolizing those hormones partially gets bypassed. With detection rates close to 100% TPVS is a powerful in localizing active endocrine islet cell tumors [85,86,87]; however, transhepatic venous sampling is an invasive procedure that requires multiple blood samples from small peripancreatic veins and thus is technically demanding and time-consuming. Because of transhepatic puncture complications affecting the liver, such as arterial bleeding, hematoma, and damaging the bile duct, may appear.…”

Section: Transhepatic Peripancreatic Venous Samplingsmentioning

confidence: 99%

Morphological and functional investigations of neuroendocrine tumors of the pancreas

Pereira

Wiskirchen

2003

Eur Radiol

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Neuroendocrine tumors of the pancreas are rare neoplasms arising predominantly from the pancreatic islets of Langerhans and are thus known as islet cell tumors. More than the half of all neuroendocrine tumors are called functioning islet cell tumors because they secrete one or more biologically active peptides that may produce clinical symptoms. Clinical diagnosis of non-functioning, i.e., biologically inactive, tumors is often delayed and patients tend to present with advanced tumors (size greater than 5 cm) that are easily localized by using conventional imaging modalities. On the other hand, symptoms of functioning islet cell tumors usually appear early in the clinical course, rendering the preoperative localization of these small hormone-producing tumors (size less than 2 cm) difficult with non-invasive methods. Since functioning islet cell tumors can often be cured by surgical resection, invasive procedures are warranted when necessary for localization diagnosis. Failure to search for, detect, and resect these small tumors will invariably result in persistent symptoms. Regarding the unsatisfactory results of morphological imaging methods, functional studies, especially arterial stimulation with hepatic venous samplings, may provide a preoperative regionalization of the pancreatic adenoma, regardless of its size.

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Localization of the source of hyperinsulinism: percutaneous transhepatic portal and pancreatic vein catheterization with hormone assay

Cited by 48 publications

References 5 publications

Localization of small islet-cell tumors. Preoperative and intraoperative ultrasound, computed tomography, arteriography, digital subtraction angiography, and pancreatic venous sampling

Localization of small islet-cell tumors. Preoperative and intraoperative ultrasound, computed tomography, arteriography, digital subtraction angiography, and pancreatic venous sampling

Intraoperative real-time ultrasonographic localization of pancreatic insulinoma: initial experience.

Morphological and functional investigations of neuroendocrine tumors of the pancreas

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