MRI

I have had two MRI scans one in UK and one in Turkey and I would say they are looking for pancreas damage.

In my case, i had an insulinoma on the head of my pancreas. They are very small tumors that are almost always benign, 5 to 10% are malignant (Steve Jobs had one), so until after surgery and a pathology report, it's considered cancer. i researched this a lot because medical procedures scare me, like xrays for example, i want to keep radiation exposure to a minimum, no unnecessary xrays. For insulinoma, the first imaging study they do is either MRI or CT scan, there are statistics showing CT has the highest success rates and other statistics showing that MRI has the higher success rate.  But because insulinoma is so small (1 to 2cm max) neither one always finds them, they are hard to find with imaging studies in a large percentage of cases.  

Since MRIs don't use radiation and CT scans use a lot, i had a preference for an MRI and i had one, after the insulinoma was diagnosed by blood test. I had read up on MRIs--sometimes contrast medium is used, sometimes not. Contrast is often supposed to give a more detailed picture but is not always necessary. The contrast medium usually used for MRI is gadolinium. Before i had the MRI, i learned that contrary to what had been believed, gadolinium is not eliminated from the body within 24 hours. There is evidence that it stay in the body indefinitely, years (published in the Journal of Radiology this year, it's very new information). This evidence was stumbled on by accident, they weren't looking for it. The places where they found that it was lingering were in the brain. I decided i wasn't going to have the contrast, there is an option to refuse it and i did.  Lots of people have it, and they are probably fine, it probably doesn't do any harm. this is just me. i decided i'd rather have radiation than gadolinium.

My MRI did not show the location on the pancreas of the insulinoma, and based on statistics, i don't think the odds were good that they would've found my tumor with the contrast.

i had my first appointment with a surgeon not long after that.  On that day, they ordered me to have a CT scan that morning, at the same medical center where i was going. The surgeon had more confidence in the technicians at the medical center, because they had a lot of experience doing it. It's believed that the quality of the image from MRI or CT, or other imaging, is operator dependent--in other words, if 50% of MRIs find a small tumor, the other 50% or some of them may not be found because of the inexperiece of the technician doing the procedure.

My insulinoma was not seen by the CT scan either, despite experienced technicians and most advanced equipment. So all that radiation for nothing. At least i didn't have gadolinium for nothing.  

I don't know about other pancreatic cancer or tumors, or other pancreatic damage, but the imaging procedure that has the best statistics for finding insulinomas on the pancreas is endoscopic ultrasound (EUS). If i had it to do over, i would just get the EUS and then go to the surgeon, hopefully with the tumor located.

The surgeon ordered EUS after the CT scan didn't show the tumor.  EUS is done under general anaesthesia where they go down your throat with a small ultrasound device and they are able to get a view of the pancreas. My tumor was found by the EUS and the doctor who performed it gave me a print out with pictures of it. For me at least, it wasn't a hard procedure.   It didn't take very long and no after effects as far as i could tell, no radiation.  

So after that, they knew the tumor was on the head of the pancreas. Even still, during surgery, they had a really hard time finding it but eventually they did.  

So, yes, MRI can detect at least some lesions on the pancreas, a lot of things show up on MRI. But at least in the case of the really small kind of tumor i had, a large percentage of MRIs (and other imaging types) don't find them.  Even EUS only finds a few more than what are found by CT scans, i was told by the doctor that did it.

Hi there, did you ever get the surgery? I've been suffering with hypoglacemia for 6 years now they think I might have a proiunsulinoma even more rare than just insuloma, Ive been managing through strict diet, Grains and certain fruits trigger the attacks. I prefer to live with whatever I have then go through surgery from what I understand being in the head of the pancreas is more complicated. I hope all is well with you and hope to here from you as its good to support one another through times like these. God bless...

Hello all - A very close family member was recently diagnosed with Pancreatic Caner in Oct 2016 and it was found in her blood work. After under going MRI and CT's to find nothing, She had severe stomach and back pain that strongly resembled Gerd. In short, I do not beleive MRI's are very realiable at least in our case.