Early-Phase Thin-Slice CT in the Diagnosis of Small Insulinomas

  • Hideki Ishioka Department of Surgery, Jichi Medical University. Tochigi, Japan
  • Naohiro Sata Department of Surgery, Jichi Medical University. Tochigi, Japan
  • Yasunao Ishiguro Department of Surgery, Jichi Medical University. Tochigi, Japan
  • Alan Lefor Department of Surgery, Jichi Medical University. Tochigi, Japan
  • Yoshikazu Yasuda Department of Surgery, Jichi Medical University. Tochigi, Japan
Keywords: Insulinoma, Pancreas, Pancreatic Polypeptide

Abstract

Context Insulinomas, which are generally smaller than 2 cm, may be difficult to detect by routine imaging modalities including abdominal ultrasonography, computed tomography, and magnetic resonance imaging. Although preoperative detection of insulinomas is essential for operative planning, it is often challenging due to their small size. While arterial stimulation and venous sampling has been used in patients with insulinomas it has been largely supplanted by early-phase thin-slice computed tomography. Case report We report three patients with insulinomas, which were not detected by routine computed tomography scan, but were successfully imaged using early-phase thin-slice computed tomography. Enucleation was performed in all patients based on preoperative imaging. All three patients had an unremarkable postoperative course. Conclusion Early-phase thin-slice computed tomography is recommended for the preoperative identification of insulinomas. This non-invasive imaging technique should be considered before performing arterial stimulation and venous sampling.

Image. CT scan before and 35, 55, and 80 seconds after the administration of contrast agent.

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CT scan before and 35, 55, and 80 seconds after the administration of contrast agent
Published
2015-01-31
How to Cite
Ishioka, H., Sata, N., Ishiguro, Y., Lefor, A., & Yasuda, Y. (2015). Early-Phase Thin-Slice CT in the Diagnosis of Small Insulinomas. JOP. Journal of the Pancreas, 16(1), 70-73. https://doi.org/10.6092/1590-8577/2901
Section
CASE REPORTS