دورية أكاديمية
Avoiding Pitfalls in Insulinomas by Preoperative Localization with a Dual Imaging Approach.
العنوان: | Avoiding Pitfalls in Insulinomas by Preoperative Localization with a Dual Imaging Approach. |
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المؤلفون: | Ramonell KM, Saunders ND, Sarmiento J, Bercu Z, Martin L, Weber CJ, Sharma J, Patel SG |
المصدر: | The American surgeon [Am Surg] 2019 Jul 01; Vol. 85 (7), pp. 742-746. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: SAGE Publications in association with Southeastern Surgical Congress Country of Publication: United States NLM ID: 0370522 Publication Model: Print Cited Medium: Internet ISSN: 1555-9823 (Electronic) Linking ISSN: 00031348 NLM ISO Abbreviation: Am Surg Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2020- : [Thousand Oaks, CA] : SAGE Publications in association with Southeastern Surgical Congress Original Publication: Atlanta Ga : Southeastern Surgical Congress |
مواضيع طبية MeSH: | Insulinoma/*diagnostic imaging , Multimodal Imaging/*methods , Pancreatic Neoplasms/*diagnostic imaging, Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Insulinoma/surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pancreatectomy ; Pancreatic Neoplasms/surgery ; Preoperative Care/methods ; Radionuclide Imaging/methods ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult |
مستخلص: | Insulinomas are rare endocrine malignancies of the pancreas that require surgical resection but can be difficult to localize preoperatively. We sought to review and improve the accuracy of preoperative localization techniques at our institution. We retrospectively reviewed all insulinomas that underwent resection at our institution between 1998 and 2016. Localization techniques include selective arterial calcium stimulation (CaStim), CT, MRI, angiography, and somatostatin receptor scintigraphy. Thirty-eight patients had pathologically proven insulinomas on surgical resection. Localization accuracies of CaStim, CT, and MRI were 89 per cent (31/35), 67 per cent (22/33), and 46 per cent (11/24), respectively. When compared with CT alone and CaStim alone, the combination of these two modalities resulted in 100 per cent preoperative localization (30/30), whereas the use of CaStim alone resulted in 80 per cent (4/5) localization and the use of CT alone resulted in 66 per cent (2/3) localization. Four of our patients had both negative CT and MRI. Among these patients, CaStim was 100 per cent localizing and the only positive modality for these patients. These data confirm that CaStim is accurate in preoperatively identifying single and multiple insulinomas; and when combined with CT, this accuracy is increased to 100 per cent. Based on these data, we propose that a dual imaging approach is a superior means of preoperative localization. |
تواريخ الأحداث: | Date Created: 20190814 Date Completed: 20190816 Latest Revision: 20190816 |
رمز التحديث: | 20221213 |
PMID: | 31405420 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1555-9823 |
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