Localization of insulinomas: Comparison of conventional arterial stimulation with venous sampling (ASVS) and superselective ASVS

Baba, Yasutaka; Miyazono, Nobuaki; Nakajo, Masayuki; Kanetsuki, I; Nishi, H.; Inoue, Hiroki

doi:10.1080/028418500127345000

Cited by 24 publications

(19 citation statements)

References 14 publications

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“…Somatostatin receptor scintigraphy (SRS) using radiolabeled octreotide is extremely sensitive in detecting gastrin-producing tumors, but is less sensitive in the visualization of insulinomas (14). Selective catheterization techniques can be applied to determine whether different pancreatic regions harbor endocrine active tumors (15), but the utilization of these methods can be limited by their invasive nature.…”

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confidence: 99%

Endoscopic Ultrasonography for Preoperative Diagnosis and Localization of Insulinomas

Nesje

Varhaug²,

Husebye³

et al. 2002

Scandinavian Journal of Gastroenterology

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confidence: 99%

Endoscopic Ultrasonography for Preoperative Diagnosis and Localization of Insulinomas

Nesje

Varhaug²,

Husebye³

et al. 2002

Scandinavian Journal of Gastroenterology

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“…11,22,[33][34][35] SRS has become the primary diagnostic imaging technique for the identification and staging of malignant PETs in humans [9][10][11][12]14 and is considered more sensitive in detecting metastases than conventional US and CT. 11,13,14 Lesion detection with SRS depends on the accumulation of radioactivity, which is determined primarily by the size of the lesion and the density of somatostatin receptors. 36 The primary tumors detected in this study were relatively small (md-Control Յ 2 cm in 10/14) compared with malignant PETs such as pancreatic gastrinomas (2-3 cm).…”

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confidence: 99%

Comparison of Ultrasonography, Computed Tomography, and Single‐Photon Emission Computed Tomography for the Detection and Localization of Canine Insulinoma

Robbena

Pollak

Kirpensteijn

et al. 2005

Veterinary Internal Medicne

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Accurate preoperative detection, localization, and staging of the primary tumor and metastases are essential for the selection of appropriate candidates for surgery. In dogs with insulinoma, preoperative assessment usually is performed with transabdominal ultrasonography (US). There are no reports on the use of computed tomography (CT) for this purpose. The preoperative use of somatostatin receptor scintigraphy (SRS) recently has been advocated for the identification of insulinoma and gastrinoma in dogs, but its accuracy remains to be established. In this report US, CT, and single-photon emission computed tomography (SPECT) with [ 111 In-DTPA-D-Phe 1 ]-octreotide (a specific form of SRS) were compared for their effectiveness in detecting and localizing primary and metastatic insulinoma in dogs. Findings at surgery or postmortem examination served as control. Of 14 primary insulinomas, 5, 10, and 6 were correctly identified by US, CT, and SPECT, respectively. No lymph node metastases were detected by US or SPECT. CT identified 2 of 5 lymph node metastases but also identified 28 false-positive lesions. Two of 4 livers were found to be positive for metastases by 1 of the imaging techniques. US can be used for the initial evaluation of dogs with hypoglycemia. Although CT identifies most primary tumors, intraoperative inspection and palpation of the pancreas is still superior. SPECT appears as effective as US and CT in detecting insulinomas. Future developments in preoperative imaging techniques might improve current methods of canine insulinoma detection.Key words: Abdominal ultrasonography; Computed tomography; Diagnostic imaging; Dog; Pancreatic endocrine tumor; Somatostatin receptor scintigraphy. Insulin-producing pancreatic endocrine tumor, or insulinoma, is the most common of the 3 types of pancreatic endocrine tumor (PET) described in the dog (insulinoma, gastrinoma, and glucagonoma).1-3 Over 95% of insulinomas in dogs are malignant, and 40-50% have visibly metastasized at the time of surgery.2,4,5 Insulinomas are identified and staged by means of preoperative transabdominal ultrasonography (US) and, to a lesser extent, by computed tomography (CT) and by inspection and palpation during exploratory laparotomy.Data on the effectiveness of preoperative imaging techniques in dogs with insulinoma are limited to uncontrolled studies of transabdominal US. [6][7][8] In human medicine, several imaging techniques have been described and evaluated for preoperative identification and staging of PETs. Somatostatin receptor scintigraphy (SRS) has become an important and often 1st-line imaging method in humans with malignant PETs. [9][10][11][12] This imaging modality has a high sensitivity and a high specificity. [13][14][15] Additional advantages of this technique are whole-body scanning for extra-abdominal metastases, gamma probing for intraoperative identification of tumor foci, and selection of subjects suitable for treatment with a radiolabeled somatostatin analogue. otide was described for identification of insulinoma...

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“…Durante a realização do exame é necessário que a glicemia seja monitorada e que todo o material para corrigir hipoglicemia grave esteja preparado para utilização em caso de emergência. Embora a incidência de complicações seja baixa, pacientes recebendo digitálicos devem ser cuidadosamente observados, devido a possível ocorrência de arritmia (13,14) . Pode ocorrer também a indução de pancreatite pelo cálcio.…”

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Utilização do estímulo superseletivo arterial com cálcio e coleta venenosa hepática (EACV) no diagnóstico pré-operatório do insulinoma: relato de caso e revisão da literatura

et al. 2004

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Azevedo F et al. Radiol Bras 2004;37(3):223225 223O objetivo deste trabalho é apresentar um caso de insulinoma oculto corretamente identificado pelo EACV, descrever a téc-nica do exame e fazer revisão sobre o diagnóstico pré-operatório deste tumor. RELATO DO CASOPaciente do sexo feminino, 19 anos de idade, começou a apresentar, em março de 2001, episódios de síncope, relacionados a dificuldade de concentração, ganho de peso e a tonteira. Em um dos episódios apresentou crise convulsiva, quando foi iniciado tratamento com carbamazepina (300 mg/dia). A paciente continuou a apresentar os sintomas, até que, durante uma internação, foi evidenciada hipoglicemia. Insulinomas ocultos são tumores não detectáveis aos exames convencionais. O estímulo superseletivo arterial com cálcio e coleta venosa hepática (EACV) é um exame que pode ser utilizado para localizar o segmento pancreático acometido pelo tumor. Relatamos o caso de uma paciente com insulinoma oculto detectado por meio do EACV. Além disso, são discutidos aspectos técnicos da realização do exame. Unitermos: Insulinoma; Pâncreas; Estímulo arterial com coleta venosa (EACV).Use of the selective arterial calcium stimulation and hepatic venous sampling (ASVS) in the preoperatory diagnosis of insulinoma: a case report and review of the literature. Occult insulinomas are tumors which are not identified by conventional tests. Selective arterial calcium stimulation and hepatic venous sampling (ASVS) can be used to identify the pancreatic segment where the tumor is located. We report the case of a patient with clinically proven insulinoma detected only by ASVS. The details of the procedure are also discussed. minuição importante dos episódios de hipoglicemia. Foram então realizadas ultrasonografia (US) abdominal, tomografia computadorizada (TC) helicoidal e ressonância magnética (RM), no Hospital Universitário Clementino Fraga Filho (HU-CFF), todos com resultados negativos. A paciente foi submetida a arteriografia pancreática, também negativa. Durante este exame, foi realizado EACV. Estímulo superseletivo arterial com cálcio e coleta venosa hepáticaUm cateter foi introduzido na veia hepática direita, através de punção da veia femoral. Após cateterização da artéria femoral, realizou-se arteriografia pancreáti-ca, incluindo injeções de contraste nas artérias gastroduodenal (AGD), esplênica proximal -porção proximal (AEPP), esplênica proximal -porção distal (AEPD) e mesentérica superior (AMS). Em cada uma dessas artérias foi injetado gluconato de cálcio (0,025 mEq/kg) diluído em bolus de 5 ml. O tempo decorrido entre cada injeção de cálcio foi de pelo menos cinco minutos. Amostras de sangue foram obtidas da veia hepática direita antes e 30, 60 e 120 segundos após a infusão do cálcio. Relato de Caso INTRODUÇÃOInsulinomas são tumores pancreáticos que, quando adequadamente identificados e tratados, apresentam elevado índice de cura. Devido ao seu pequeno tamanho, sua localização nem sempre é realizada com facilidade. Nos últimos anos vem aumentando a ocorrência de tumores não det...

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Localization of insulinomas: Comparison of conventional arterial stimulation with venous sampling (ASVS) and superselective ASVS

Abstract: SS-ASVS is a useful method for detailed evaluation of overproduction of insulin from pancreatic insulinomas and their localization. When the pancreatic insulinoma is situated in the pancreatic body or tail, the localization is more accurately made by SS-ASVS than by conventional ASVS.

Cited by 24 publications

References 14 publications

Endoscopic Ultrasonography for Preoperative Diagnosis and Localization of Insulinomas

Endoscopic Ultrasonography for Preoperative Diagnosis and Localization of Insulinomas

Comparison of Ultrasonography, Computed Tomography, and Single‐Photon Emission Computed Tomography for the Detection and Localization of Canine Insulinoma

Utilização do estímulo superseletivo arterial com cálcio e coleta venenosa hepática (EACV) no diagnóstico pré-operatório do insulinoma: relato de caso e revisão da literatura

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