Selective Angiography in Localizing Islet-Cell Tumors of the Pancreas

Forty insulin-producing islet-cell tumors of the pancreas excised from 26 patients were studied with preoperative pancreatic angiography. In 14 patients, at least 1 tumor was identified by angiography. Of 24 tumors 1 or more centimeters in diameter, 12 were correctly localized, and of 16 less than 1 cm, 3 were visualized. Overall detection rate was 15 of 40 tumors (38%). Localization was more frequent in tumors with increased vascularity histologically, and in those located in the head of the pancreas. Adenomatosis was associated with tumor in 3 cases but was not apparent angiographically. Super-selective angiography, vasoconstrictive pharmacoangiography, and subtraction techniques were occasionally helpful.