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The value of multidetector-row CT in the preoperative detection of pancreatic insulinomas

Il valore della TC multistrato nell’identificazione preoperatoria degli insulinomi pancreatici

  • Abdominal Radiology/Radiologia Addominale
  • Published:
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Abstract

Purpose

The authors sought to quantitatively analyse enhancement characteristics of pancreatic insulinomas in different phases and determine the value of multidetector-row computed tomography (CT) for detecting insulinomas.

Materials and methods

Forty-six patients with surgically proven insulinomas diagnosed between 2002 and 2007 were retrospectively reviewed. These patients underwent single-phase (group 1) or dual-phase (group 2) helical CT scanning.

Results

Sensitivity for detecting insulinomas in group 2 was superior to that in group 1 (p<0.05).The sensitivity for insulinoma detection in the arterial phase was superior to that in the portal-venous phase (p<0.05). The mean attenuation values of the insulinomas and normal pancreas during the unenhanced arterial and portal-venous phases were, respectively, 40.5±8.75 HU (Hounsfield units), 114.48±27.30 HU, 112.19±19.52 HU and 44.56±6.48 HU, 81.16±15.22 HU, 90.54±13.80 HU, and there was statistical difference between them (p=0.000). The contrast enhancement of insulinomas in the arterial and portal-venous phases was 74.03±29.51 HU and 70.90±21.93 HU, respectively, and there was no statistical difference between them (p=0.499). The tumour to normal-pancreas attenuation differences in the arterial and portal-venous phases were respectively 33.32±20.96 HU and 20.58±16.32 HU, respectively, and there was statistical difference between them (p=0.011).

Conclusions

Dual-phase CT has a promising sensitivity in detecting pancreatic insulinomas. The acquisition of images in the arterial phase is more helpful for detecting insulinomas.

Riassunto

Obiettivo

Analizzare quantitativamente le caratteristiche post-contrastografiche degli insulinomi pancreatici nelle diverse fasi e determinare il valore della TC multistrato nel riconoscimento di questi tumori.

Materiali e metodi

Quarantasei pazienti con insulinoma pancreatico confermato all’intervento chirurgico, diagnosticati tra il 2002 e il 2007, sono stati rivalutati retrospettivamente. I pazienti sono stati esaminati mediante esame TC nella sola fase portale - gruppo 1 - e in fase arteriosa e venosa portale - gruppo 2.

Risultati

La sensibilità nel riconoscimento di insulinoma è risultata superiore nel gruppo 2 rispetto al gruppo 1 (p<0,05). La sensibilità nel riconoscimento di insulinoma è risultata superiore nella fase arteriosa rispetto alla fase portale (p<0,05). I valori di attenuazione medi degli insulinomi e del pancreas normale nelle fasi precontrastografiche arteriosa e portale erano, rispettivamente, pari a 40,5±8,75 UH, 114,48±27,30 UH, 112,19±19,52 UH e 44,56±6,48 UH, 81,16±15.22 UH, 90,54±13,80 UH, con differenze statisticamente significative in tutti i casi (p<0,000). L’enhancement degli insulinomi nelle fasi arteriosa e portale era pari a 74,03±29,51 UH e 70,90±21,93 UH, rispettivamente, senza differenze statisticamente significative (p=0,499). Le differenze di attenuazione tumore-pancreas normale nelle fasi arteriosa e venosa portale erano rispettivamente 33,32±20,96 UH e 20,58±16,32 UH, rispettivamente, con differenza statisticamente significativa (p=0,011).

Conclusioni

La TC nelle due fasi arteriosa e venosa portale ha una sensibilità promettente nella identificazione degli insulinomi pancreatici. L’acquisizione delle immagini nella fase arteriosa è la più utile nel riconoscimento di questi tumori.

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References/Bibliografia

  1. Horton KM, Hruban RH, Yeo C et al (2006) Multi-detector row CT of pancreatic islet cell tumors. Radiographics 26:453–464

    Article  PubMed  Google Scholar 

  2. Hashimoto LA, Walsh RM (1999) Preoperative localization of insulinomas is not necessary. J Am Coll Surg 189:368–373

    Article  CAS  PubMed  Google Scholar 

  3. Fidler JL, Fletcher JG, Reading CC et al (2003) Preoperative detection of pancreatic insulinomas on multiphasic helical CT. AJR Am J Roentgenol 181:775–780

    CAS  PubMed  Google Scholar 

  4. King AD, Ko GT, Yeung VT et al (1998) Dual phase spiral CT in detecting small insulinomas of the pancreas. Brit J Radiol 71:20–23

    CAS  PubMed  Google Scholar 

  5. Ichikawa T, Peterson MS, Federle MP et al (2000) Islet cell tumor of the pancreas: biphasic CT versus MR imaging in tumor detection. Radiology 216:163–171

    CAS  PubMed  Google Scholar 

  6. Gouya H, Vignaux O, Augui J et al (2003) CT, endoscopic sonography, and a combined protocol for preoperative evaluation of pancreatic insulinomas. AJR Am J Roentgenol 181:987–992

    PubMed  Google Scholar 

  7. Keogan MT, McDermott VG, Paulson EK et al (1997) Pancreatic malignancy: effect of dual-phase helical CT in tumor detection and vascular opacification. Radiology 205:513–518

    CAS  PubMed  Google Scholar 

  8. Fletcher JG, Wiersema MJ, Farrell MA et al (2003) Pancreatic malignancy: Value of arterial, pancreatic,and hepatic phase imaging with multi-detector row CT. Radiology 229:81–90

    Article  PubMed  Google Scholar 

  9. Boland GW, O’Malley ME, Saez M, Fernandez-del-Castillo C et al (1999) Pancreatic-phase versus portal vein-phase helical CT of the pancreas: optimal temporal window for evaluation of pancreatic adenocarcinoma. AJR Am J Roentgenol 172:605–608

    CAS  PubMed  Google Scholar 

  10. Thoeni RF, Mueller-Lisse UG, Chan R et al (2000) Detection of small, functional islet cell tumors in the pancreas: selection of MR imaging sequences for optimal sensitivity. Radiology 214:483–490

    CAS  PubMed  Google Scholar 

  11. Catalano C, Pavone P, Laghi A et al (1999) Localization of pancreatic insulinomas with MR imaging at 0.5 T. Acta Radiol 40:644–648

    Article  CAS  PubMed  Google Scholar 

  12. Rosch T, Lightdale CJ, Botet JF et al (1992) Localization of pancreatic endocrine tumors by endoscopic ultrasonography. N Engl J Med 326:1721–1726

    CAS  PubMed  Google Scholar 

  13. Thompson NW, Czako PF, Fritts LL et al (1994) Role of endoscopic ultrasonography in the localization of insulinomas and gastrinomas. Surgery 116:1131–1138

    CAS  PubMed  Google Scholar 

  14. De Angelis C, Repici A, Arena V et al (1998) Preoperative endoscopic ultrasonography in decision making and management for pancreatic endocrine tumors: a 6-year experience. Endoscopy 30 [suppl 1]:A182–186

    PubMed  Google Scholar 

  15. Zimmer T, Scherubl H, Faiss S et al (2000) Endoscopic ultrasonography of neuroendocrine tumours. Digestion 62 [suppl 1]:45–50

    Article  PubMed  Google Scholar 

  16. Pitre J, Soubrane O, Palazzo L et al (1996) Endoscopic ultrasonography for the preoperative localization of insulinomas. Pancreas 13:55–60

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, Ruijin Er Road, Shanghai, 200025, China

    Y. Liu, Q. Song, H.T. Jin, X.Z. Lin & K.M. Chen

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  1. Y. Liu
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  2. Q. Song
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  3. H.T. Jin
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Correspondence to K.M. Chen.

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Liu, Y., Song, Q., Jin, H. et al. The value of multidetector-row CT in the preoperative detection of pancreatic insulinomas. Radiol med 114, 1232–1238 (2009). https://doi.org/10.1007/s11547-009-0466-7

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  • DOI: https://doi.org/10.1007/s11547-009-0466-7

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