Which imaging modalities are used in the diagnosis of insulinomas?

Updated: May 31, 2020
  • Author: Zonera Ashraf Ali, MBBS; Chief Editor: Neetu Radhakrishnan, MD  more...
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Answer

Insulinomas can be located with the following imaging modalities:

  • Endoscopic ultrasonography: Detects 77% of insulinomas in the pancreas [3, 4, 5]

  • Real-time transabdominal high-resolution ultrasonography: 50% sensitivity

  • Intraoperative transabdominal high-resolution ultrasonography with the transducer wrapped in a sterile rubber glove and passed over the exposed pancreatic surface: Detects more than 90% of insulinomas

  • Computed tomography (CT) scanning: 82-94% sensitivity

  • Magnetic resonance imaging (MRI) [6]

  • Arteriography: Selective arteriography has 82% accuracy, with a 5% false-positive rate; arteriography with catheterization of small arterial branches of the celiac system combined with calcium injections and simultaneous measurements of hepatic vein insulin during each selective calcium injection localizes tumors in 47% of patients
  • PET/CT with gallium-68 DOTA-(Tyr3)-octreotate (Ga-DOTATATE): 90% sensitivoity; possible adjunct study when other imaging studies are negative and minimally invasive surgery is planned [7]

See Workup for more detail.


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