[Utility of arteriography with selective arterial calcium injection for the diagnosis of insulinoma].

Background: Common preoperative imaging techniques for the diagnosis of insulinomas do not lead to an effective localization in 40% cases. We present here our experience with arteriography followed by selective arterial calcium injection (AACI).

Method: Retrospective review of AACIs and other techniques performed in patients with endogenous hyperinsulinism.

Results: AACI either localized the tumor or at least conditional its surgical resection in nine out of 11 cases. In 2 out of 11 patients, the test yielded a negative result (factitious hypoglycemia). Only 4 tumors were identified by other techniques.

Conclusions: AACI is a first-choice technique for the preoperative localization of insulinomas. It may also help rule out other causes of hypoglycemia.