Role of Selective Angiography in the Management of Patients With Zollinger-Ellison Syndrome

ENETS Consensus Guidelines for the Management of Patients with Gastroduodenal Neoplasms

“…2 cm) [6,7,41,42,52,53,55,56,58,59] , they are frequently missed ( 1 80%) with conventional imaging studies (multislice CT scan, MRI, ultrasound, angiography) [46,60,61,64,[85][86][87][88][89] . Studies in gastrinomas demonstrate that conventional imaging studies detect ^ 15% of gastrinomas !…”

Gastrinoma (Duodenal and Pancreatic)

“…Numerous localization studies have been recommended including conventional imaging studies (CT, MRI, ultrasound), selective angiography, functional localization methods (angiography with secretin stimulation for hepatic venous gastrin gradients, portal venous sampling for gastrin gradients), somatostatin receptor scintingraphy (SRS) and endoscopic ultrasound (EUS) as well as various intraoperative localization methods, including intraoperative ultrasound, intraoperative transillumination of the duodenum [35] and routine use of a duodenotomy [21, 33, 34,36,37,38,39]. Prospective studies show for primary gastrinomas that conventional imaging studies localize 10–40%, angiography 20–50% and SRS 60–70%.The use of SRS changes management in 15–45% of patients [33, 34, 40].…”

Well-Differentiated Duodenal Tumor/Carcinoma (Excluding Gastrinomas)

“…Because duodenal NETs are generally small in size (mean 1.2–1.5 cm) (>75% <2 cm) [4, 5, 10, 11, 21, 22, 24, 25, 27, 28], they are frequently missed (>80%) with conventional imaging studies (CT, MRI, ultrasound, angiography) [15, 29, 30, 33,48,49,50,51,52]. Studies in duodenal gastrinomas demonstrate that conventional imaging studies detect ≤15% of gastrinomas <1 cm in diameter, 20–50% 1–3 cm in diameter and 95% >3 cm in diameter [48, 50, 53].…”

“…Studies in duodenal gastrinomas demonstrate that conventional imaging studies detect ≤15% of gastrinomas <1 cm in diameter, 20–50% 1–3 cm in diameter and 95% >3 cm in diameter [48, 50, 53]. …”