title: Localization of insulinomas.
abstract: OBJECTIVE
  Intraoperative ultrasonography is more sensitive than preoperative and other intraoperative techniques for localizing insulinoma.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  A tertiary referral center.
  
  
  METHODS
  All patients with a biochemical diagnosis of organic hyperinsulinism who were referred to University of California, San Francisco, from 1975 to 1998.
  
  
  METHODS
  Sensitivities of the localization techniques for insulinoma were evaluated.
  
  
  RESULTS
  The sensitivities of tumor localization with arteriography, computed tomography, preoperative ultrasonography, magnetic resonance imaging, magnetic resonance imaging with gadolinium, transhepatic venous sampling, palpation, and intraoperative ultrasonography were 47%, 24%, 50%, 30%, 40%, 55%, 76%, and 91%, respectively. Nine of the 11 nonpalpable and nonvisible tumors at operation were localized by intraoperative ultrasonography.
  
  
  CONCLUSIONS
  The currently available preoperative localization tests are not reliable enough to be recommended when intraoperative ultrasonography is available.
authors.affiliation: Department of Surgery, University of California, San Francisco 94115, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Boukhman
authors.forename: J M
authors.initials: JM
authors.lastname: Karam
authors.forename: J
authors.initials: J
authors.lastname: Shaver
authors.forename: A E
authors.initials: AE
authors.lastname: Siperstein
authors.forename: A A
authors.initials: AA
authors.lastname: DeLorimier
authors.forename: O H
authors.initials: OH
authors.lastname: Clark
mesh_terms: D000328:Adult; D003952:Diagnostic Imaging / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D007430:Intraoperative Care; D008297:Male; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography