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

Tomonobu Hatoko; Takaaki Murakami; Masakatsu Sone; Daisuke Yabe; Toshihiko Masui; Yuji Nakamoto; Akihiro Furuta; Norimitsu Uza; Yuzo Kodama; Norio Harada; Masahito Ogura; Akihiro Yasoda; Nobuya Inagaki

doi:10.2169/internalmedicine.4396-20

CASE REPORTS

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

Tomonobu Hatoko, Takaaki Murakami, Masakatsu Sone, Daisuke Yabe, Toshihiko Masui, Yuji Nakamoto, Akihiro Furuta, Norimitsu Uza, Yuzo Kodama, Norio Harada, Masahito Ogura, Akihiro Yasoda, Nobuya Inagaki

Author information

Tomonobu Hatoko
Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Japan
Takaaki Murakami
Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Japan
Masakatsu Sone
Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Japan
Daisuke Yabe
Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Japan
Department of Diabetes and Endocrinology, Graduate School of Medicine, Gifu University, Japan
Toshihiko Masui
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University Graduate School of Medicine, Japan
Yuji Nakamoto
Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Japan
Akihiro Furuta
Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Japan
Norimitsu Uza
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Japan
Yuzo Kodama
Department of Gastroenterology, Kobe University Graduate School of Medicine, Japan
Norio Harada
Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Japan
Masahito Ogura
Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Japan
Akihiro Yasoda
Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Japan
Clinical Research Center, National Hospital Organization Kyoto Medical Center, Japan
Nobuya Inagaki
Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Japan

Keywords: calcium stimulation, insulinoma, low-dose, selective arterial calcium stimulation test, selective arterial secretagogue injection test

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 19 Pages 2397-2403

DOI https://doi.org/10.2169/internalmedicine.4396-20

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Details

Abstract

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.

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