Low-dose Selective Arterial Calcium Stimulation Test for Localizing Insulinoma: A Single-center Experience of Five Consecutive Cases

• Published in: Internal Medicine Vol. 59; no. 19; pp. 2397 - 2403
• Main Authors: Hatoko, Tomonobu, Murakami, Takaaki, Sone, Masakatsu, Yabe, Daisuke, Masui, Toshihiko, Nakamoto, Yuji, Furuta, Akihiro, Uza, Norimitsu, Kodama, Yuzo, Harada, Norio, Ogura, Masahito, Yasoda, Akihiro, Inagaki, Nobuya
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.10.2020; Japan Science and Technology Agency
• Subjects: Adult; Calcium; Calcium - administration & dosage; Calcium - metabolism; calcium stimulation; Case Report; Dose-Response Relationship, Drug; Female; Hepatic Veins - metabolism; Hepatic Veins - surgery; Humans; Hypoglycemia; Injection; Insulinoma; Insulinoma - diagnosis; Insulinoma - metabolism; Insulinoma - surgery; Internal medicine; Japan; Localization; low-dose; Male; Middle Aged; Nausea; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - metabolism; Pancreatic Neoplasms - surgery; Retrospective Studies; selective arterial calcium stimulation test; selective arterial secretagogue injection test; Side effects; Treatment Outcome; Japan; selective arterial secretagogue injection test; low-dose; calcium stimulation; selective arterial calcium stimulation test; insulinoma
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.4396-20

The selective arterial calcium stimulation test (SACST) is one of the most useful localization tests for insulinoma but can cause false-positive and/or unexpected multi arterial positive results that hamper clinical decisions. There are also several adverse effects, such as nausea and hypoglycemia, at the conventional dose (0.025 mEq/kg) of calcium injection. We herein report five consecutive insulinoma cases in which low-dose (0.005-0.007 mEq/kg) calcium injection for SACST led to successful insulinoma localization. No adverse effects of SACST were observed. In conclusion, a low-dose SACST can be a favorable option as an insulinoma localization test in terms of accuracy and safety.