Detective flow imaging endoscopic ultrasound for localizing pancreatic insulinomas that are undetectable with other imaging modalities

Among pancreatic neuroendocrine tumors (PNETs), pancreatic insulinomas are often particularly difficult to detect by imaging studies, making localization diagnosis difficult [1] [2]. Recently, the new technique of detective flow imaging endoscopic ultrasound (DFI-EUS), which is capable of displaying minute blood flow in the entire pancreas without contrast medium, has been introduced. We report a pancreatic insulinoma that was difficult to detect with other imaging tests, and for which DFI-EUS was useful for tumor detection.