Should the selective arterial secretagogue injection test for insulinoma localization be evaluated at 60 or 120 seconds?

Keijiro Ueda, Tetsuhide Ito, Ken Kawabe, Lingaku Lee, Takashi Fujiyama, Yuichi Tachibana, Masami Miki, Kohei Yasunaga, Takehiro Takaoka, Akihiro Nishie, Yoshiki Asayama, Robert T. Jensen, Yoshihiro Ogawa

研究成果: ジャーナルへの寄稿記事

1 引用 (Scopus)

抄録

Objective The selective arterial secretagogue injection (SASI) test is considered indispensable for the accurate localization of insulinoma. However, the optimum timing of the post-injection evaluation is controversial, as some studies recommend 60 seconds [SASI (60 seconds)] while others support 120 seconds [SASI (120 seconds)]. The aim of this study was to determine the optimum timing for the SASI test evaluation for insulinoma localization. Methods Thirteen patients with surgically proven insulinoma were studied retrospectively. For the SASI test, immunoreactive insulin (IRI) was determined at baseline and at 30, 60, 90, and 120 seconds after calcium gluconate injection. A two-fold or greater increase in IRI over the baseline value was considered positive. The localization abilities of SASI (60 seconds) and SASI (120 seconds) were then compared. Results In 13 patients, a secretagogue was injected into 40 arteries supplying the pancreas. In the SASI (60 seconds) and SASI (120 seconds), the respective findings were as follows: positive predictive value, 72.2% and 68.2%; false positive rate, 25.0% and 35.0%; and rate of positivity in the head and body/tail, 38.5% and 46.2%. When the artery with the largest change was taken as the dominant artery, the localization detection sensitivity was 76.9% for SASI (60 seconds) and 92.3% for SASI (120 seconds). The sensitivity of morphological imaging techniques for localization ranged from 61.5-91.7%. Conclusion Compared with SASI (60 seconds) or morphological imaging, the insulinoma localization ability of SASI (120 seconds) was superior. Given these findings, we believe that the IRI level should be measured at 120 seconds in the SASI test.

元の言語英語
ページ(範囲)2985-2991
ページ数7
ジャーナルInternal Medicine
56
発行部数22
DOI
出版物ステータス出版済み - 1 1 2017

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Insulinoma
Injections
Arteries
Insulin
Calcium Gluconate

All Science Journal Classification (ASJC) codes

  • Internal Medicine

これを引用

Should the selective arterial secretagogue injection test for insulinoma localization be evaluated at 60 or 120 seconds? / Ueda, Keijiro; Ito, Tetsuhide; Kawabe, Ken; Lee, Lingaku; Fujiyama, Takashi; Tachibana, Yuichi; Miki, Masami; Yasunaga, Kohei; Takaoka, Takehiro; Nishie, Akihiro; Asayama, Yoshiki; Jensen, Robert T.; Ogawa, Yoshihiro.

:: Internal Medicine, 巻 56, 番号 22, 01.01.2017, p. 2985-2991.

研究成果: ジャーナルへの寄稿記事

Ueda, K, Ito, T, Kawabe, K, Lee, L, Fujiyama, T, Tachibana, Y, Miki, M, Yasunaga, K, Takaoka, T, Nishie, A, Asayama, Y, Jensen, RT & Ogawa, Y 2017, 'Should the selective arterial secretagogue injection test for insulinoma localization be evaluated at 60 or 120 seconds?', Internal Medicine, 巻. 56, 番号 22, pp. 2985-2991. https://doi.org/10.2169/internalmedicine.9107-17
Ueda, Keijiro ; Ito, Tetsuhide ; Kawabe, Ken ; Lee, Lingaku ; Fujiyama, Takashi ; Tachibana, Yuichi ; Miki, Masami ; Yasunaga, Kohei ; Takaoka, Takehiro ; Nishie, Akihiro ; Asayama, Yoshiki ; Jensen, Robert T. ; Ogawa, Yoshihiro. / Should the selective arterial secretagogue injection test for insulinoma localization be evaluated at 60 or 120 seconds?. :: Internal Medicine. 2017 ; 巻 56, 番号 22. pp. 2985-2991.
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title = "Should the selective arterial secretagogue injection test for insulinoma localization be evaluated at 60 or 120 seconds?",
abstract = "Objective The selective arterial secretagogue injection (SASI) test is considered indispensable for the accurate localization of insulinoma. However, the optimum timing of the post-injection evaluation is controversial, as some studies recommend 60 seconds [SASI (60 seconds)] while others support 120 seconds [SASI (120 seconds)]. The aim of this study was to determine the optimum timing for the SASI test evaluation for insulinoma localization. Methods Thirteen patients with surgically proven insulinoma were studied retrospectively. For the SASI test, immunoreactive insulin (IRI) was determined at baseline and at 30, 60, 90, and 120 seconds after calcium gluconate injection. A two-fold or greater increase in IRI over the baseline value was considered positive. The localization abilities of SASI (60 seconds) and SASI (120 seconds) were then compared. Results In 13 patients, a secretagogue was injected into 40 arteries supplying the pancreas. In the SASI (60 seconds) and SASI (120 seconds), the respective findings were as follows: positive predictive value, 72.2{\%} and 68.2{\%}; false positive rate, 25.0{\%} and 35.0{\%}; and rate of positivity in the head and body/tail, 38.5{\%} and 46.2{\%}. When the artery with the largest change was taken as the dominant artery, the localization detection sensitivity was 76.9{\%} for SASI (60 seconds) and 92.3{\%} for SASI (120 seconds). The sensitivity of morphological imaging techniques for localization ranged from 61.5-91.7{\%}. Conclusion Compared with SASI (60 seconds) or morphological imaging, the insulinoma localization ability of SASI (120 seconds) was superior. Given these findings, we believe that the IRI level should be measured at 120 seconds in the SASI test.",
author = "Keijiro Ueda and Tetsuhide Ito and Ken Kawabe and Lingaku Lee and Takashi Fujiyama and Yuichi Tachibana and Masami Miki and Kohei Yasunaga and Takehiro Takaoka and Akihiro Nishie and Yoshiki Asayama and Jensen, {Robert T.} and Yoshihiro Ogawa",
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T1 - Should the selective arterial secretagogue injection test for insulinoma localization be evaluated at 60 or 120 seconds?

AU - Ueda, Keijiro

AU - Ito, Tetsuhide

AU - Kawabe, Ken

AU - Lee, Lingaku

AU - Fujiyama, Takashi

AU - Tachibana, Yuichi

AU - Miki, Masami

AU - Yasunaga, Kohei

AU - Takaoka, Takehiro

AU - Nishie, Akihiro

AU - Asayama, Yoshiki

AU - Jensen, Robert T.

AU - Ogawa, Yoshihiro

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Objective The selective arterial secretagogue injection (SASI) test is considered indispensable for the accurate localization of insulinoma. However, the optimum timing of the post-injection evaluation is controversial, as some studies recommend 60 seconds [SASI (60 seconds)] while others support 120 seconds [SASI (120 seconds)]. The aim of this study was to determine the optimum timing for the SASI test evaluation for insulinoma localization. Methods Thirteen patients with surgically proven insulinoma were studied retrospectively. For the SASI test, immunoreactive insulin (IRI) was determined at baseline and at 30, 60, 90, and 120 seconds after calcium gluconate injection. A two-fold or greater increase in IRI over the baseline value was considered positive. The localization abilities of SASI (60 seconds) and SASI (120 seconds) were then compared. Results In 13 patients, a secretagogue was injected into 40 arteries supplying the pancreas. In the SASI (60 seconds) and SASI (120 seconds), the respective findings were as follows: positive predictive value, 72.2% and 68.2%; false positive rate, 25.0% and 35.0%; and rate of positivity in the head and body/tail, 38.5% and 46.2%. When the artery with the largest change was taken as the dominant artery, the localization detection sensitivity was 76.9% for SASI (60 seconds) and 92.3% for SASI (120 seconds). The sensitivity of morphological imaging techniques for localization ranged from 61.5-91.7%. Conclusion Compared with SASI (60 seconds) or morphological imaging, the insulinoma localization ability of SASI (120 seconds) was superior. Given these findings, we believe that the IRI level should be measured at 120 seconds in the SASI test.

AB - Objective The selective arterial secretagogue injection (SASI) test is considered indispensable for the accurate localization of insulinoma. However, the optimum timing of the post-injection evaluation is controversial, as some studies recommend 60 seconds [SASI (60 seconds)] while others support 120 seconds [SASI (120 seconds)]. The aim of this study was to determine the optimum timing for the SASI test evaluation for insulinoma localization. Methods Thirteen patients with surgically proven insulinoma were studied retrospectively. For the SASI test, immunoreactive insulin (IRI) was determined at baseline and at 30, 60, 90, and 120 seconds after calcium gluconate injection. A two-fold or greater increase in IRI over the baseline value was considered positive. The localization abilities of SASI (60 seconds) and SASI (120 seconds) were then compared. Results In 13 patients, a secretagogue was injected into 40 arteries supplying the pancreas. In the SASI (60 seconds) and SASI (120 seconds), the respective findings were as follows: positive predictive value, 72.2% and 68.2%; false positive rate, 25.0% and 35.0%; and rate of positivity in the head and body/tail, 38.5% and 46.2%. When the artery with the largest change was taken as the dominant artery, the localization detection sensitivity was 76.9% for SASI (60 seconds) and 92.3% for SASI (120 seconds). The sensitivity of morphological imaging techniques for localization ranged from 61.5-91.7%. Conclusion Compared with SASI (60 seconds) or morphological imaging, the insulinoma localization ability of SASI (120 seconds) was superior. Given these findings, we believe that the IRI level should be measured at 120 seconds in the SASI test.

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U2 - 10.2169/internalmedicine.9107-17

DO - 10.2169/internalmedicine.9107-17

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