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Insulinoma : Radiology

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Insulinoma : Imaging: Imaging modalities such as CT, MRI, and endoscopic ultrasound are utilized to localize the tumor/s so that the type and extent of surgery can be planned. On imaging studies, insulinomas appear as small (usually <2.0 cm), well-defined hypervascular tumors that may be found anywhere in the pancreas. They may contain calcifications.

Octreotide scintigraphy (aka Somatostatin Receptor Scintigraphy): This is a nuclear medicine scan which utilizes radiolabeled Octreotide - a synthetic analog of somatostatin. About 80% of insulinomas express somatostatin receptors. Radiolabeled octreotide has high affinity for these receptors and is a sensitive marker for the diagnosis of insulinomas, especially the small, well-differentiated tumors.

More recently, PET/CT utilizing radiolabeled glucagon-like peptide-1 (GLP-1) receptor analog has been used to localize small insulinomas as shown in this image. Case courtesy of Dr Bruno Di Muzio, Radiopaedia.org. From the case rID: 74282

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