Diagnostic Value of ASVS for Insulinoma Localization: A Systematic Review and Meta-analysis

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2019 Nov 20

PMID 31743337

Citations 5

Authors

Hao Wang

Ying Ba

Qian Xing

Run-Ce Cai

Affiliations

Soon will be listed here.

Abstract

Background: Previous studies on the diagnostic value of arterial calcium stimulation with hepatic venous sampling (ASVS) for the localization of insulinoma have reported inconsistent results. Here, we performed a meta-analysis of the relevant published studies.

Methods: PubMed, Embase, Web of Science, the Cochrane Library, and Wanfang Data were searched for studies on the diagnostic value of ASVS in insulinoma localization published up to May 2019. We calculated the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and receiver operating characteristic (ROC) curve of ASVS in the localization of insulinoma.

Results: We included ten studies involving 337 patients in the study. The pooled sensitivity, specificity, PLR, and NLR were 0.93 (95% confidence interval [CI]: 0.83-0.97), 0.86 (95%CI: 0.75-0.93), 6.8(95%CI: 3.7-12.7), and 0.08 (95%CI: 0.03-0.19), respectively. The DOR was 84 (95%CI: 30-233), and the area under the ROC curve was 0.96 (95%CI: 0.94-0.97).The results of the heterogeneity of the studies (P = 0.00, I2 = 80.17) were calculated using forest plots of the DOR.

Conclusion: ASVS is of significant value in localization of insulinoma. If a qualitative diagnosis of insulinoma is definite and the imaging examination results are negative, ASVS should be performed to confirm the localization of insulinoma.

Citing Articles

Contemporary Approaches to the Surgical Management of Pancreatic Neuroendocrine Tumors.

Kartik A, Armstrong V, Stucky C, Wasif N, Fong Z Cancers (Basel). 2024; 16(8).

PMID: 38672582 PMC: 11048062. DOI: 10.3390/cancers16081501.

Approach to the Patient: Insulinoma.

Hofland J, Refardt J, Feelders R, Christ E, de Herder W J Clin Endocrinol Metab. 2023; 109(4):1109-1118.

PMID: 37925662 PMC: 10940262. DOI: 10.1210/clinem/dgad641.

The comparison of three different molecular imaging methods in localization and grading of insulinoma.

Chang L, Bi X, Li S, Tong Q, Gu Y, He Z Front Endocrinol (Lausanne). 2023; 14:1163176.

PMID: 37455905 PMC: 10348808. DOI: 10.3389/fendo.2023.1163176.

Ectopic insulinoma: a systematic review.

Guerrero-Perez F, Vilarrasa N, Huanuco L, Busquets J, Secanella L, Vercher-Conejero J Rev Endocr Metab Disord. 2023; 24(6):1135-1146.

PMID: 37434098 DOI: 10.1007/s11154-023-09824-2.

A case report of insulinoma presenting with seizures and localized on endoscopic ultrasound.

Umer W, Mohammed A, Khan A, Saddique M, Zahid M Clin Case Rep. 2023; 11(3):e6967.

PMID: 36937638 PMC: 10014521. DOI: 10.1002/ccr3.6967.

References

Abboud B, Boujaoude J . Occult sporadic insulinoma: localization and surgical strategy. World J Gastroenterol. 2008; 14(5):657-65. PMC: 2683990. DOI: 10.3748/wjg.14.657. View

Druce M, Muthuppalaniappan V, OLeary B, Chew S, Drake W, Monson J . Diagnosis and localisation of insulinoma: the value of modern magnetic resonance imaging in conjunction with calcium stimulation catheterisation. Eur J Endocrinol. 2010; 162(5):971-8. DOI: 10.1530/EJE-10-0056. View

Deeks J, Macaskill P, Irwig L . The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol. 2005; 58(9):882-93. DOI: 10.1016/j.jclinepi.2005.01.016. View

DerSimonian R, Laird N . Meta-analysis in clinical trials. Control Clin Trials. 1986; 7(3):177-88. DOI: 10.1016/0197-2456(86)90046-2. View

OShea D, LYNN J, Jackson J, Bloom S . Localization of insulinomas by selective intraarterial calcium injection. J Clin Endocrinol Metab. 1996; 81(4):1623-7. DOI: 10.1210/jcem.81.4.8636378. View

Doppman J, Chang R, Fraker D, Norton J, Alexander H, Miller D . Localization of insulinomas to regions of the pancreas by intra-arterial stimulation with calcium. Ann Intern Med. 1995; 123(4):269-73. DOI: 10.7326/0003-4819-123-4-199508150-00004. View

Tseng L, Chen J, Won J, Tseng H, Yang A, Wang S . The role of intra-arterial calcium stimulation test with hepatic venous sampling (IACS) in the management of occult insulinomas. Ann Surg Oncol. 2007; 14(7):2121-7. DOI: 10.1245/s10434-007-9398-4. View

Wiesli P, Brandle M, Pfammatter T, Zapf J, Spinas G, Schmid C . Insulin determination by specific and unspecific immunoassays in patients with insulinoma evaluated by the arterial stimulation and venous sampling test. Eur J Endocrinol. 2004; 151(1):123-6. DOI: 10.1530/eje.0.1510123. View

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. PMC: 2707599. DOI: 10.1371/journal.pmed.1000097. View

10.

Jyotsna V, Rangel N, Pal S, Seith A, Sahni P, Ammini A . Insulinoma: Diagnosis and surgical treatment. Retrospective analysis of 31 cases. Indian J Gastroenterol. 2006; 25(5):244-7. View

11.

Pereira P, Roche A, Maier G, Huppert P, Dammann F, Farnsworth C . Insulinoma and islet cell hyperplasia: value of the calcium intraarterial stimulation test when findings of other preoperative studies are negative. Radiology. 1998; 206(3):703-9. DOI: 10.1148/radiology.206.3.9494488. View

12.

Thompson S, Vella A, Thompson G, Rumilla K, Service F, Grant C . Selective Arterial Calcium Stimulation With Hepatic Venous Sampling Differentiates Insulinoma From Nesidioblastosis. J Clin Endocrinol Metab. 2015; 100(11):4189-97. PMC: 4702445. DOI: 10.1210/jc.2015-2404. View

13.

Glover J, Shorvon P, Lees W . Endoscopic ultrasound for localisation of islet cell tumours. Gut. 1992; 33(1):108-10. PMC: 1373874. DOI: 10.1136/gut.33.1.108. View

14.

Service F, McMahon M, OBrien P, Ballard D . Functioning insulinoma--incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo Clin Proc. 1991; 66(7):711-9. DOI: 10.1016/s0025-6196(12)62083-7. View

15.

Daggett P, Goodburn E, Kurtz A, Le Quesne L, Morris D, Nabarro J . Is preoperative localisation of insulinomas necessary?. Lancet. 1981; 1(8218):483-6. DOI: 10.1016/s0140-6736(81)91859-6. View

16.

Luo Y, Pan Q, Yao S, Yu M, Wu W, Xue H . Glucagon-Like Peptide-1 Receptor PET/CT with 68Ga-NOTA-Exendin-4 for Detecting Localized Insulinoma: A Prospective Cohort Study. J Nucl Med. 2016; 57(5):715-20. PMC: 5227553. DOI: 10.2967/jnumed.115.167445. View

17.

Boukhman M, KARAM J, Shaver J, Siperstein A, Duh Q, Clark O . Insulinoma--experience from 1950 to 1995. West J Med. 1998; 169(2):98-104. PMC: 1305178. View

18.

Altman D, Bland J . Interaction revisited: the difference between two estimates. BMJ. 2003; 326(7382):219. PMC: 1125071. DOI: 10.1136/bmj.326.7382.219. View

19.

Whiting P, Weswood M, Rutjes A, Reitsma J, Bossuyt P, Kleijnen J . Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies. BMC Med Res Methodol. 2006; 6:9. PMC: 1421422. DOI: 10.1186/1471-2288-6-9. View

20.

Braatvedt G, Jennison E, Holdaway I . Comparison of two low-dose calcium infusion schedules for localization of insulinomas by selective pancreatic arterial injection with hepatic venous sampling for insulin. Clin Endocrinol (Oxf). 2013; 80(1):80-4. DOI: 10.1111/cen.12253. View