Diffusion-weighted magnetic resonance imaging in the diagnosis of pancreatic insulinoma: a clinical case

Abstract

The topical diagnosis of insulinoma continues to be an actual problem of modern medicine due to low detection rate of the tumor (about 75%) and inconsistent data on its localization when using various methods of visualization (more than in 50% of cases), as well as the lack of a single diagnostic algorithm. In the clinical practice, many different imaging assessments are conducted, including those with the administration of contrast agents and associated with radiation load, as well as invasive studies, associated with risk of various complications, high costs and duration of the examination. Thus, the search for highly sensitive and safe methods of topical diagnosis of the insulin-producing pancreatic tumor seems relevant. In the presented clinical case, the diagnosis of insulinoma is verified by diffusion-weighted magnetic resonance imaging (DW-MRI). It is an accurate and non-invasive method that does not involve exposure to ionizing radiation and does not require any administration of contrast agents. This technology, based on microstructural pathological changes, allows to identify small tumors and to make a differential diagnosis of benign and malignant neoplasms. However, at present the experience of DW-MRI use for the diagnosis of an insulin-producing neuroendocrine tumor is limited. Evaluation of its effectiveness in a large patient cohort would be necessary to assess the prospects for its introduction into clinical practice.

About the authors

M. Yu. Yukina

Endocrinology Research Center

Author for correspondence.
Email: kuronova@yandex.ru

Marina Yu. Yukina – MD, PhD, Leading Research Fellow, Department of Therapeutic Endocrinology.

11 Dmitriya Ul'yanova ul., Moscow, 117036, Tel.: +7 (495) 668 20 73,  +7 (926) 267 47 71

Russian Federation

N. F. Nuralieva

Endocrinology Research Center

Email: fake@neicon.ru

Nurana F. Nuralieva – MD, Research Fellow, Department of Therapeutic Endocrinology.

11 Dmitriya Ul'yanova ul., Moscow, 117036

Russian Federation

E. A. Troshina

Endocrinology Research Center

Email: fake@neicon.ru

Ekaterina A. Troshina – Corresponding Member of the RAS, MD, PhD, Professor, Head of Department of Therapeutic Endocrinology.

11 Dmitriya Ul'yanova ul., Moscow, 117036

Russian Federation

A. V. Vorontsov

Endocrinology Research Center

Email: fake@neicon.ru

Alexander V. Vorontsov – MD, PhD, Professor, Head of Department of Magnetic Resonance Imaging and Department of Computed Tomography.

11 Dmitriya Ul'yanova ul., Moscow, 117036

Russian Federation

V. P. Vladimirova

Endocrinology Research Center

Email: fake@neicon.ru

Victoria P. Vladimirova – MD, PhD, Leading Research Fellow, Department of Magnetic Resonance Imaging and Department of Computed Tomography.

11 Dmitriya Ul'yanova ul., Moscow, 117036

Russian Federation

T. V. Soldatova

Endocrinology Research Center

Email: fake@neicon.ru

Tat'yana V. Soldatova – MD, PhD, Head of Department of Ultrasound Diagnostics.

11 Dmitriya Ul'yanova ul., Moscow, 117036

Russian Federation

N. S. Kuznetsov

Endocrinology Research Center

Email: fake@neicon.ru

Nikolay S. Kuznetsov – MD, PhD, Professor, Head of Department of Surgery.

11 Dmitriya Ul'yanova ul., Moscow, 117036

Russian Federation

N. V. Latkina

Endocrinology Research Center

Email: fake@neicon.ru

Nonna V. Latkina – MD, PhD, Surgeon, Department of Surgery.

11 Dmitriya Ul'yanova ul., Moscow, 117036

Russian Federation

N. S. Izmaylova

Endocrinology Research Center

Email: fake@neicon.ru

Natal'ya S. Izmailova – MD, PhD, Research Fellow, Department of Fundamental Pathomorphology.

11 Dmitriya Ul'yanova ul., Moscow, 117036

Russian Federation

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Copyright (c) 2018 Yukina M.Y., Nuralieva N.F., Troshina E.A., Vorontsov A.V., Vladimirova V.P., Soldatova T.V., Kuznetsov N.S., Latkina N.V., Izmaylova N.S.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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