Arterial stimulation with simultaneous venous sampling for localizing insulinomas
Zhiyuan Wu1, Tingwei Su2, Daming Wu3
1Department of Interventional Radiology, Ruijin Hospital, affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Journal of Interventional Medicine
|November 22, 2021
Summary
Arterial stimulation with simultaneous venous sampling (ASVS) accurately locates insulinomas, improving preoperative diagnosis. This minimally invasive technique is recommended for patients with suspected insulinomas.
Area of Science:
- Endocrinology
- Interventional Radiology
- Surgical Oncology
Background:
- Insulinomas are rare neuroendocrine tumors causing hypoglycemia.
- Accurate preoperative localization is crucial for successful surgical resection.
- Arterial stimulation with simultaneous venous sampling (ASVS) is an emerging technique for tumor localization.
Observation:
- Selective angiographies and ASVS were performed on 20 patients with pathologically confirmed insulinomas.
- Tumor characteristics including number, location, and size were recorded.
- Pancreatic arterial variants were noted in some cases.
Findings:
- ASVS achieved 85% accuracy using biochemical data alone and 95% accuracy with biochemical data and angiography.
- The technique successfully identified 22 insulinomas, with a mean size of 1.40±0.60cm.
- Variant arterial anatomy was identified in two false localization cases.
Implications:
- ASVS demonstrates high accuracy for preoperative insulinoma localization.
- This method can guide surgical planning and improve patient outcomes.
- ASVS should be considered for most patients with suspected insulinomas.
