Essentials of insulinoma localization with selective arterial calcium stimulation and hepatic venous sampling

Abstract

Insulinomas are the most common functional pancreatic neuroendocrine tumor. Most insulinomas canbe localized non-invasivel ywith cross-sectional and nuclear imaging. Selectivearterial calcium stimulation and hepatic venous sampling is an effective and safe minimally-invasive procedure for insulinoma localization that may be utilized when non-invasive techniques are inconclusive. The procedure’s technical success and proper interpretation of its results is dependent on the interventional radiologist’s knowledge of normal and variant pancreatic arterial perfusion. Accurate pre-operative localization aids in successful surgical resection. Technical and anatomic considerations of insulinoma localization with selective arterial calcium stimulation and hepatic venous sampling are reviewed.