Digestive Disease Interventions
DOI: 10.1055/s-0041-1723804
Review Article

Selective Intra-Arterial Calcium Stimulation Venous Sampling Test for Preoperative Localization of Occult Neuroendocrine Tumors: Recall for an Old Technique

Mangaladevi S. Patil
1  Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
Nariman Nezami
2  Section of Vascular and Interventional Radiology, Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
3  Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
Zachary L. Bercu
3  Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
Louis G. Martin
3  Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
Sean R. Dariushnia
3  Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
Minzhi Xing
3  Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
Janice Newsome
3  Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
Nima Kokabi
3  Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
› Author Affiliations
Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Abstract

Background Surgical resection is the curative treatment for neuroendocrine tumors (NETs). Noninvasive imaging is unreliable in localizing NETs measuring less than 2 cm. This study investigates the safety and efficacy of the selective intra-arterial calcium stimulation venous sampling test (SACST) for preoperative localization of functional NETs within the pancreas.

Methods This retrospective analysis of the patients referred for localization of radiologically occult functional NETs from 2004 to 2019 was performed at a single institution. The technical success, diagnostic accuracy, and complications of the test were evaluated.

Results Twenty-three patients underwent SACST. The SACST was technically successful in 100% of the patients. Lesions were successfully localized in 19 (83%) patients. Tumor blush was seen in one patient. The mean ± standard deviation of maximal dimension of the resected tumor was 2.0 ± 1.9 cm. Sensitivity, specificity, positive predictive value, and negative predictive value of the SACST for localization of all lesions were 1.0, 0.57, 0.84, and 1.0, as well as 1.0, 0.57, 0.80, and 1.0 for insulinomas, respectively.

Conclusion SACST is a feasible, safe, well-tolerated, and effective procedure to preoperatively localize radiologically occult NETs within the pancreas.



Publication History

Received: 29 August 2020

Accepted: 06 January 2021

Publication Date:
11 February 2021 (online)

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