The Value of Hybrid Angio-CT in Preoperative Detection and Localization of Insulinomas: A Single-Center Retrospective Study.

Abstract

To investigate the performance of hybrid angio-CT in preoperative detection and localization for insulinomas. Fifty-four postoperative pathology-confirmed patients from April 2015 to March 2017 were retrospectively reviewed; all patients underwent angio-CT with administration of contrast media in SMA, GDA and SA due to negative, inconclusive or controversial findings by several preoperative diagnostic methods including TAUS, CEUS, EUS, ECT, EMRI and DSA. Surgery was used as gold standard for localization of insulinomas; detection sensitivity and localization accuracy of angio-CT were assessed and compared with other preoperative image options. Fifty-six benign insulinomas (mean diameter, 15.8mm) in 54 patients (18 men and 36 women) were found according to surgical results; the overall detection sensitivity of TAUS, CEUS, EUS, ECT, EMRI and DSA was 21.4, 78.4, 79.2, 70.0, 79.2 and 72.2%, respectively. The overall localization accuracy was 14.3, 58.8, 68.8, 60.0, 75.0 and 44.4%, respectively. A total of 53 tumors were detected by angio-CT, 51 tumors were accurately located, and the overall detection sensitivity and localization accuracy of angio-CT was 94.4 and 90.7%, which was significantly higher than that of all other preoperative diagnostic methods (p<0.05). No any serious complications occurred during angio-CT. Our study indicates the great potential value of angio-CT in the preoperative detection and localization of insulinomas; angio-CT can be used as a preferred invasive diagnostic method.