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Diagnostic accuracy of selective arterial calcium injection test for localization of gastrinoma.
Endocr J. 2020 Mar 28; 67(3):305-315.EJ

Abstract

The appropriate localization of gastrinoma is still difficult. We aimed to evaluate the diagnostic accuracy of selective arterial calcium injection (SACI) for localization of gastrinomas including multiple lesions. This retrospective study included ten patients with surgically proven gastrinomas (gastrinoma group) and six patients without any findings suggesting Zollinger-Ellison syndrome (non-gastrinoma group). For SACI, calcium gluconate was injected into the arteries supplying pancreas, duodenum, and liver. Blood samples from the hepatic vein were obtained before and 30, 60, and 120 seconds after each injection. The results were considered positive when the increase in serum immunoreactive gastrin (IRG) levels within 60 seconds of calcium gluconate injection were more than 80 pg/mL and more than 20% from baseline. We evaluated the efficacy of SACI by comparing the SACI responses with definitive locations diagnosed by clinical and histopathological findings. In the gastrinoma group, false-positive responses were confirmed in seven of the ten patients. False-negative response was observed in one of the feeding arteries of one patient with gastrinomas in multiple locations. Conversely, the greatest increase in serum gastrin levels from baseline at 30 seconds indicated the true-positive responses in all patients with gastrinomas. In the non-gastrinoma group, calcium gluconate injection into gastroduodenal artery evoked positive responses in five of the six patients. In conclusion, our data suggest the strongest gastrin response evoked by SACI indicates the definitive location in patients with gastrinomas. In contrast, SACI could not accurately locate multiple gastrin-secreting lesions due to poor specificity.

Authors+Show Affiliations

Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Department of Endocrinology and Metabolism, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Department of Endocrinology, Yokohama City Minato Red Cross Hospital, Kanagawa, Japan.Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Department of Endocrinology and Metabolism, Soka Municipal Hospital, Saitama, Japan.Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Department of Diabetes and Endocrinology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.Department of Diagnostic Radiology and Nuclear Medicine, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.Department of Diagnostic Radiology and Nuclear Medicine, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31813923

Citation

Hayashi, Ruriko, et al. "Diagnostic Accuracy of Selective Arterial Calcium Injection Test for Localization of Gastrinoma." Endocrine Journal, vol. 67, no. 3, 2020, pp. 305-315.
Hayashi R, Minami I, Sasahara Y, et al. Diagnostic accuracy of selective arterial calcium injection test for localization of gastrinoma. Endocr J. 2020;67(3):305-315.
Hayashi, R., Minami, I., Sasahara, Y., Izumiyama, H., Yoshimoto, T., Kishino, M., Kudo, A., Tateishi, U., Tanabe, M., & Yamada, T. (2020). Diagnostic accuracy of selective arterial calcium injection test for localization of gastrinoma. Endocrine Journal, 67(3), 305-315. https://doi.org/10.1507/endocrj.EJ19-0413
Hayashi R, et al. Diagnostic Accuracy of Selective Arterial Calcium Injection Test for Localization of Gastrinoma. Endocr J. 2020 Mar 28;67(3):305-315. PubMed PMID: 31813923.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic accuracy of selective arterial calcium injection test for localization of gastrinoma. AU - Hayashi,Ruriko, AU - Minami,Isao, AU - Sasahara,Yuriko, AU - Izumiyama,Hajime, AU - Yoshimoto,Takanobu, AU - Kishino,Mitsuhiro, AU - Kudo,Atsushi, AU - Tateishi,Ukihide, AU - Tanabe,Minoru, AU - Yamada,Tetsuya, Y1 - 2019/12/07/ PY - 2019/12/10/pubmed PY - 2019/12/10/medline PY - 2019/12/10/entrez KW - Gastrin KW - Gastrinoma KW - Selective arterial calcium injection KW - Zollinger-Ellison syndrome SP - 305 EP - 315 JF - Endocrine journal JO - Endocr. J. VL - 67 IS - 3 N2 - The appropriate localization of gastrinoma is still difficult. We aimed to evaluate the diagnostic accuracy of selective arterial calcium injection (SACI) for localization of gastrinomas including multiple lesions. This retrospective study included ten patients with surgically proven gastrinomas (gastrinoma group) and six patients without any findings suggesting Zollinger-Ellison syndrome (non-gastrinoma group). For SACI, calcium gluconate was injected into the arteries supplying pancreas, duodenum, and liver. Blood samples from the hepatic vein were obtained before and 30, 60, and 120 seconds after each injection. The results were considered positive when the increase in serum immunoreactive gastrin (IRG) levels within 60 seconds of calcium gluconate injection were more than 80 pg/mL and more than 20% from baseline. We evaluated the efficacy of SACI by comparing the SACI responses with definitive locations diagnosed by clinical and histopathological findings. In the gastrinoma group, false-positive responses were confirmed in seven of the ten patients. False-negative response was observed in one of the feeding arteries of one patient with gastrinomas in multiple locations. Conversely, the greatest increase in serum gastrin levels from baseline at 30 seconds indicated the true-positive responses in all patients with gastrinomas. In the non-gastrinoma group, calcium gluconate injection into gastroduodenal artery evoked positive responses in five of the six patients. In conclusion, our data suggest the strongest gastrin response evoked by SACI indicates the definitive location in patients with gastrinomas. In contrast, SACI could not accurately locate multiple gastrin-secreting lesions due to poor specificity. SN - 1348-4540 UR - https://www.unboundmedicine.com/medline/citation/31813923/Diagnostic_accuracy_of_selective_arterial_calcium_injection_test_for_localization_of_gastrinoma L2 - https://dx.doi.org/10.1507/endocrj.EJ19-0413 DB - PRIME DP - Unbound Medicine ER -
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