Magnetic resonance imaging of endocrine tumours of the pancreas

Moore, N. W.; Rogers, C E; Britton, B. J.

doi:10.1259/0007-1285-68-808-341

Cited by 35 publications

(19 citation statements)

References 17 publications

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“…This was also reported in a previous study from this institution. 10 The overall accuracy of non-invasive tests in our study was only 25% (PPV, 67%) and this compares with other studies. 9 The accuracy of selective angiography was 44% and THPVS was 40%.…”

Section: Discussionsupporting

confidence: 68%

Surgical Approach to Insulinomas: Are Pre-Operative Localisation Tests Necessary?

Ravi

Britton

2007

annals

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Insulinoma is a rare and elusive, but the most common, curable endocrine tumour of the pancreas. The incidence is estimated at 4 cases per million-person years.1 The ability to localise the tumour accurately before or during surgery is an important factor in the management of these lesions. In the event of failed localisation, a blind pancreatic resection is no longer recommended. The development of sensitive radioimmunoassays to detect endogenous hyperinsulinaemia resulted in extensive investigations to localise the tumour preoperatively, in the belief that this would reduce morbidity from pancreatic exploration. These pre-operative tests included ultrasound scans (USS), computerised tomography (CT), magnetic resonance imaging (MRI), selective angiography, transhepatic portal venous sampling (THPVS), endoscopic ultrasound (EUS), octreotide scans and calcium stimulation arteriography. There is a wide variation in the sensitivity of these tests and there is no clear consensus in the choice of these tests even amongst enthusiasts.2,3 Some believe that meticulous intra-operative exploration combined with intra-operative ultrasound (IOUS) has a higher sensitivity than pre-operative localisation tests. 4,5 We have reviewed our experience of these lesions to assess if pre-operative localisation tests are necessary and to formulate a rational management strategy for these lesions. Insulinoma is a rare, but curable, endocrine tumour. The ability to localise the tumour accurately before or during surgery is an important factor in the management of these elusive lesions, which has been extensively debated. We have reviewed our experience of these lesions to establish the role of localisation tests. SURGICAL ONCOLOGY

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Section: Discussionsupporting

confidence: 68%

Surgical Approach to Insulinomas: Are Pre-Operative Localisation Tests Necessary?

Ravi

Britton

2007

annals

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“…CT scan had a diagnostic sensitivity of 62% in this study. Dynamic contrast-enhanced MRI with fast spin echo and fat saturation technique has a sensitivity of 70–73% in detection of NETs and insulinomas [29,30,31,32,33]. MRI had a sensitivity of 82% in this study.…”

Section: Discussionmentioning

confidence: 69%

Preoperative Localisation and Surgical Management of Insulinoma: Single Centre Experience

Varma¹,

Tariciotti²,

Coldham

et al. 2011

Dig Surg

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Background: The majority of insulinomas are benign, small and intrapancreatic. Preoperative localisation is important to plan the surgical management. Methods: We retrospectively analysed our data on the preoperative imaging, type of surgery and histopathological features of the operated patients with an insulinoma from January 1993 to March 2010. Univariate and multivariate analyses were performed to detect the predictive factors for survival following surgery. Results: Forty patients were operated on for insulinoma, of which 33 were benign and 7 were malignant. The sensitivity of preoperative computed tomogram scan, magnetic resonance imaging and endoscopic ultrasound, for localising the lesions was 62, 82 and 94%, respectively. Enucleation was performed in 21 (52.5%) patients, and remaining had pancreatic resection. Hepatic resection was performed in 2 and liver transplantation in 1 patient. Morbidity and perioperative mortality was 17 (42.5%) and 1 (2.7%), respectively. The overall 5- and 10-year survival was 89 and 86.5%, respectively. The presence of metastases was found to be an independent predictor of poor survival on multivariate analysis. Conclusion: Preoperative computed tomogram/magnetic resonance imaging and endoscopic ultrasound are sensitive in localizing the majority of insulinomas. Surgery offers a good long-term survival, even in patients with malignant insulinoma.

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“…Others have described MRI detection rates of up to 65.5% [11,24,28,[30][31][32]. Short inversion-time recovery sequences and fat-suppressed T2-weighted TSE images seem to provide the best images [33][34][35][36][37], and the use of contrast agents is mandatory. Thirteen patients were investigated in our series; the sensitivity was 85% and the smallest tumour diameter was 8 mm.…”

Section: Discussionmentioning

confidence: 99%

The importance of preoperative localisation procedures in organic hyperinsulinism — Experience in 67 patients

Kaczirek

Ba‐Ssalamah

Schima

et al. 2004

Wien Klin Wochenschr

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Magnetic resonance imaging of endocrine tumours of the pancreas

Cited by 35 publications

References 17 publications

Surgical Approach to Insulinomas: Are Pre-Operative Localisation Tests Necessary?

Surgical Approach to Insulinomas: Are Pre-Operative Localisation Tests Necessary?

Preoperative Localisation and Surgical Management of Insulinoma: Single Centre Experience

The importance of preoperative localisation procedures in organic hyperinsulinism — Experience in 67 patients

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