Assessment of selective arterial calcium stimulation and hepatic venous sampling to localize insulin‐secreting tumours

Brändle, Michael; Pfammatter, Thomas; Spinas, Giatgen A.; Lehmann, Roger; Schmid, Christoph

doi:10.1046/j.1365-2265.2001.01335.x

Cited by 57 publications

(28 citation statements)

References 22 publications

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“…5,6 Venous sampling for proteins secreted by endocrine tumors (parathyroid hormone, insulin, aldosterone, and calcitonin) has been used to localize tumors based on gradients in the protein level. [7][8][9][10][11] It is unknown whether there is a venous gradient in the serum Tg level in patients with DTC. For the current study, we measured serum Tg levels in the vein that drained the DTC directly (the internal jugular vein) and in the peripheral vein (the forearm antecubital vein) in 15 patients who were undergoing surgical treatment for DTC.…”

Section: Discussionmentioning

confidence: 99%

“…Venous sampling and measurement of proteins or peptides secreted by endocrine tumors, such as insulinoma (insulin), parathyroid tumors (intact parathyroid hormone), gastrinoma (gastrin stimulation test), adrenocortical tumors (aldosterone), and medullary thyroid cancer (calcitonin), have been used to localize tumors that cannot be detected by conventional imaging studies. [7][8][9][10][11][12][13][14] Although the half-life of Tg is long (range, 6-96 hours) compared with other proteins that are secreted by endocrine tumors and depends on liver function, Tg levels close to the tumor were significantly higher than Tg levels in the peripheral venous circulation in all but 1 patient who had lung metastasis. 15 The current results suggest that venous sampling for Tg in patients with increasing or high serum Tg levels but negative imaging studies may be useful to localize DTC.…”

Section: Discussionmentioning

confidence: 99%

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Patients with differentiated thyroid cancer have a venous gradient in thyroglobulin levels

Kebebew¹,

Reiff²

2007

Cancer

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BACKGROUND.Although serum thyroglobulin (Tg) is an excellent marker for detecting recurrent or persistent differentiated thyroid cancer (DTC), it is unreliable in patients who have positive anti‐Tg antibodies. Furthermore, a growing number of patients with DTC have elevated Tg levels but no detectable disease on radioiodine scanning or other imaging studies. The objective of this study was to determine whether a gradient in Tg protein level exists in patients with DTC.METHODS.Fifteen patients who underwent thyroidectomy and/or lymph node dissection for primary DTC (n = 10 patients) and recurrent or persistent DTC (n = 5 patients). A venipuncture was performed simultaneously from the internal jugular vein adjacent to the tumor and the ipsilateral antecubital vein. Venous Tg protein levels were measured by using a chemiluminescence assay.RESULTS.The average internal jugular‐to‐antecubital vein Tg protein ratio was 3.4:1.0 (median Tg ratio, 2.9:1; range, 0.8–62.2). Four patients had positive anti‐Tg antibodies but still had a Tg gradient. Tg levels were significantly higher in the adjacent internal jugular vein than in the antecubital vein (P = .0019). The Tg ratio between the internal jugular and antecubital veins was significantly higher in patients with recurrent or persistent DTC than in patients with primary tumors (P = .0196).CONCLUSIONS.To the authors' knowledge, this is the first study to document a venous gradient in Tg protein levels in patients with DTC. The findings suggested that venous sampling for Tg may be used to localize DTC in some patients who have high or increasing serum Tg levels but negative radioiodine scans or imaging studies. Cancer 2007 © 2007 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Patients with differentiated thyroid cancer have a venous gradient in thyroglobulin levels

Kebebew¹,

Reiff²

2007

Cancer

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“…Ultrasound, CT, and MRI are the commonly used diagnostic imaging methods for pancreatic endocrine tumors, while angiography is considered the most effective method (although more invasive) for detecting such tumors since these lesions are frequently hypervascular (3). Arterial stimulation and venous sampling (ASVS) is known to be useful for localizing insulinoma and gastrinoma, with a high detection sensitivity for insulinoma being reported (4)(5)(6)(7)(8), but its usefulness for detecting glucagonoma has not been determined. Here, we report a case of MEN1 in which glucagonoma was located by ASVS with calcium loading.…”

Section: Multiple Endocrine Neoplasia Type 1 (Men1) Is a Multiple Endmentioning

confidence: 99%

Glucagonoma Diagnosed by Arterial Stimulation and Venous Sampling (ASVS)

et al. 2009

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“…By contrast, arterial stimulation and venous sampling (ASVS) is an important technique for determining the localization of insulinomas (1,2). The ASVS method was originally reported by Doppman et al in 1991 (1), and there have been several subsequent reports of its success in localizing insulinomas (3,4). The principle behind ASVS is that insulin secretion is promoted from insulinoma cells by the injection of calcium into the insulinoma-feeding artery (5).…”

Section: Introductionmentioning

confidence: 99%

Insulinoma cell calcium-sensing receptor influences insulin secretion in a case with concurrent familial hypocalciuric hypercalcemia and malignant metastatic insulinoma.

Ono¹,

Oda²,

Ishihara³

et al. 2008

European Journal of Endocrinology

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Context and objective: Arterial stimulation and venous sampling (ASVS) is an important technique for localizing insulinoma. The principle behind ASVS is that insulin secretion is promoted from insulinoma cells by the injection of calcium into the insulinoma-feeding artery. However, the mechanism for ASVS-induced insulin secretion remains unclear. Both insulinoma and familial hypocalciuric hypercalcemia (FHH) are rare diseases. This study reports on a case in which both of these diseases occur concurrently. Design and patient: The patient with FHH also suffered from insulinoma. We reasoned that insulin secretion for ASVS is dependent on the calcium-sensing receptor (CaSR). ASVS was performed on this patient. The expression of the CaSR protein and corresponding mRNA were confirmed. Results: No significant changes in the plasma levels of insulin and C-peptide were observed during ASVS. The patient was clinically diagnosed as having FHH. We confirmed that a mutation in the CaSR gene was present in the genomic DNA of this patient and that there were no mutations in the multiple endocrine neoplasia type 1 gene. In addition, expression of both CaSR mRNA and CaSR protein was confirmed in the insulinoma samples. Conclusion: These results suggest that the CaSR gene is involved in ASVS-induced insulin secretion.European Journal of Endocrinology 159 81-86

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Assessment of selective arterial calcium stimulation and hepatic venous sampling to localize insulin‐secreting tumours

Abstract: Arterial stimulation and hepatic venous sampling is a very sensitive technique for preoperative localization of insulin-producing tumours. It can help to plan minimally invasive surgery and to select an appropriate strategy for patients suffering from malignant tumours in others.

Cited by 57 publications

References 22 publications

Patients with differentiated thyroid cancer have a venous gradient in thyroglobulin levels

Patients with differentiated thyroid cancer have a venous gradient in thyroglobulin levels

Glucagonoma Diagnosed by Arterial Stimulation and Venous Sampling (ASVS)

Insulinoma cell calcium-sensing receptor influences insulin secretion in a case with concurrent familial hypocalciuric hypercalcemia and malignant metastatic insulinoma.

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