Insulinoma other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]


Arterial calcium stimulation with hepatic venous sampling (ASVS) is an invasive diagnostic study which is used when all other imaging studies are inconclusive. ASVS is also the diagnostic test of choice for endogenous hyperinsulinism. Findings are noted after calcium stimulation of tumor supplying arteries and in the hepatic venous samples which show the positive response of a two-fold or greater increase in insulin levels.

Arterial Calcium Stimulation with Hepatic Venous Sampling

Basis of ASVS


  1. Moreno-Moreno P, Alhambra-Expósito MR, Herrera-Martínez AD, Palomares-Ortega R, Zurera-Tendero L, Espejo Herrero JJ, Gálvez-Moreno MA (2016). "Arterial Calcium Stimulation with Hepatic Venous Sampling in the Localization Diagnosis of Endogenous Hyperinsulinism". Int J Endocrinol. 2016: 4581094. doi:10.1155/2016/4581094. PMC 5066019. PMID 27795707.
  2. Grover AC, Skarulis M, Alexander HR, Pingpank JF, Javor ED, Chang R, Shawker T, Gorden P, Cochran C, Libutti SK (2005). "A prospective evaluation of laparoscopic exploration with intraoperative ultrasound as a technique for localizing sporadic insulinomas". Surgery. 138 (6): 1003–8, discussion 1008. doi:10.1016/j.surg.2005.09.017. PMID 16360384.
  3. Brown CK, Bartlett DL, Doppman JL, Gorden P, Libutti SK, Fraker DL, Shawker TH, Skarulis MC, Alexander HR (1997). "Intraarterial calcium stimulation and intraoperative ultrasonography in the localization and resection of insulinomas". Surgery. 122 (6): 1189–93, discussion 1193–4. PMID 9426437.
  4. Tseng LM, Chen JY, Won JG, Tseng HS, Yang AH, Wang SE, Lee CH (2007). "The role of intra-arterial calcium stimulation test with hepatic venous sampling (IACS) in the management of occult insulinomas". Ann. Surg. Oncol. 14 (7): 2121–7. doi:10.1245/s10434-007-9398-4. PMID 17431724.
  5. Baba Y, Miyazono N, Nakajo M, Kanetsuki I, Nishi H, Inoue H (2000). "Localization of insulinomas. Comparison of conventional arterial stimulation with venous sampling (ASVS) and superselective ASVS". Acta Radiol. 41 (2): 172–7. PMID 10741793.