TABLE 2

Preoperative Imaging and Operative Procedures

Procedure	Patient 1	Patient 2	Patient 3	Patient 4	Patient 5
Conventional imaging
CT	FN	NA	NA	NA	NA
ASVS	FN	FN	NA	NA	NA
Endoscopic ultrasound	FN	FN	FN	NA	NC
MR imaging	FN	FN	FN	−	TP
¹¹¹In-DOTA-exendin-4 SPECT/CT
Detection of tumor 4 h after injection	FN	TP	TP	+	FN
Tumor-to-background ratio at 4 h	NA	1.04	3.87	1.96	NA
Detection of tumor 72 h after injection	FP	TP	TP	+	FP
Tumor-to-background ratio at 72 h	NA	1.12	3.93	2.04	NA
⁶⁸Ga-DOTA-exendin-4 PET/CT
Detection of tumor	TP	TP	TP	+	TP
Tumor-to-background ratio	2.00	3.79	6.87	5.95	32.42
SUV_max of tumor	5.5	10.8	49.1	25	30.8
Surgery and histology
Surgical procedure	Enucleation	Pancreas tail resection	Pancreas tail resection	Not operated	Enucleation
Localization	Body/tail transition	Tail	Tail	NA	Tail
Dimension (mm)	8	10	10	NA	18
Histopathology	Insulinoma	Insulinoma	Insulinoma	NA	Insulinoma

ASVS = selective arterial calcium stimulation and hepatic venous sampling; SUV_max = maximal standardized uptake value; NA = not applicable; NC = not conclusive; FN = false-negative; FP = false-positive; TP = true-positive; − = negative result; + = positive result.