SCT and Hypoglycemia: The increase of serum immunoreactive insulin levels in response to secretin is significantly lower than in normal persons.20 A combination of gadolinium MRI, triple-phase CT, octreotide scanning, selective intra-arterial calcium stimulation, and particularly endoscopic and intraoperative ultrasound may actually detect almost all lesions.21 The initial treatment of childhood insulinoma is dietary and focused on preventing hypoglycemia.