Angiographic localization of beta cell tumours

Angiography was carried out on 28 patients by which a beta cell tumour was verified in 21. One case was excluded as no final diagnosis was established. Angiography correctly localized 14/17 adenomas (82%) and 3/4 carcinomas (75%), in total 17/21 tumours (81%). The adenomas were equally distributed throughout the pancreas. Three false negative diagnoses included an adenoma in the head of pancreas seen in retrospect, a hypovascular adenoma in the head of pancreas and an adenoma in the tail of pancreas which probably was hidden by the spleen. All carcinomas were located in the body and tail of pancreas. Metastases to the liver were demonstrated in two cases, although present in all. One carcinoma was not distinguished from superimposed metastases in the left lobe of the liver. A false positive diagnosis was reported in 3/7 cases (57%). One resulted from accumulation of contrast in the duodenal mucosa, another from a small accessory spleen in the tail of pancreas and the third was probably due to contrast accumulation in the body of pancreas seen 'end-on'. A false positive diagnosis may also derive from contrast accumulation in a hyperplastic lymphnode, a penetrating gatroduodenal ulcer, a pancreatic haemangioma or metastasis. Diagnostic specificity was 0.85, sensitivity 0.43.