Chin-Chen Chang1, Bo-Ching Lee1, Yeun-Chung Chang1, Vin-Cent Wu2, Kuo-How Huang3, Kao-Lang Liu4. 1. Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung-Shan South Road, Taipei, 100, Taiwan. 2. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung-Shan South Road, Taipei, 100, Taiwan. 3. Department of Urology, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung-Shan South Road, Taipei, 100, Taiwan. 4. Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung-Shan South Road, Taipei, 100, Taiwan. lkl@ntu.edu.tw.
Abstract
OBJECTIVES: To compare the performance of on-site quick cortisol assay (QCA) and C-arm computed tomography (CT) assistance on adrenal venous sampling (AVS) without adrenocorticotropic hormone stimulation. METHODS: The institutional review board at our hospital approved this retrospective study, which included 178 consecutive patients with primary aldosteronism. During AVS, we used C-arm CT to confirm right adrenal cannulation between May 2012 and June 2015 (n = 100) and QCA for bilateral adrenal cannulation between July 2015 and September 2016 (n = 78). Successful AVS required a selectivity index (cortisoladrenal vein/cortisolperipheral) of ≥ 2.0 bilaterally. RESULTS: The overall success rate of C-arm CT-assisted AVS was 87%, which increased to 97.4% under QCA (P = .013). The procedure time (C-arm CT, 49.5 ± 21.3 min; QCA, 37.5 ± 15.6 min; P < .001) and radiation dose (C-arm CT, 673.9 ± 613.8 mGy; QCA, 346.4 ± 387.8 mGy; P < .001) were also improved. The resampling rate was 16% and 21.8% for C-arm CT and QCA, respectively. The initial success rate of the performing radiologist remained stable during the study period (C-arm CT 75%; QCA, 82.1%, P = .259). CONCLUSIONS: QCA might be superior to C-arm CT for improving the performance of AVS. KEY POINTS: • Adrenal venous sampling (AVS) is a technically challenging procedure. • C-arm CT and quick cortisol assay (QCA) are efficient for assisting AVS. • QCA might outperform C-arm CT in enhancing AVS performance.
OBJECTIVES: To compare the performance of on-site quick cortisol assay (QCA) and C-arm computed tomography (CT) assistance on adrenal venous sampling (AVS) without adrenocorticotropic hormone stimulation. METHODS: The institutional review board at our hospital approved this retrospective study, which included 178 consecutive patients with primary aldosteronism. During AVS, we used C-arm CT to confirm right adrenal cannulation between May 2012 and June 2015 (n = 100) and QCA for bilateral adrenal cannulation between July 2015 and September 2016 (n = 78). Successful AVS required a selectivity index (cortisoladrenal vein/cortisolperipheral) of ≥ 2.0 bilaterally. RESULTS: The overall success rate of C-arm CT-assisted AVS was 87%, which increased to 97.4% under QCA (P = .013). The procedure time (C-arm CT, 49.5 ± 21.3 min; QCA, 37.5 ± 15.6 min; P < .001) and radiation dose (C-arm CT, 673.9 ± 613.8 mGy; QCA, 346.4 ± 387.8 mGy; P < .001) were also improved. The resampling rate was 16% and 21.8% for C-arm CT and QCA, respectively. The initial success rate of the performing radiologist remained stable during the study period (C-arm CT 75%; QCA, 82.1%, P = .259). CONCLUSIONS: QCA might be superior to C-arm CT for improving the performance of AVS. KEY POINTS: • Adrenal venous sampling (AVS) is a technically challenging procedure. • C-arm CT and quick cortisol assay (QCA) are efficient for assisting AVS. • QCA might outperform C-arm CT in enhancing AVS performance.
Authors: William F Young; Anthony W Stanson; Geoffrey B Thompson; Clive S Grant; David R Farley; Jon A van Heerden Journal: Surgery Date: 2004-12 Impact factor: 3.982
Authors: Gian Paolo Rossi; Marlena Barisa; Bruno Allolio; Richard J Auchus; Laurence Amar; Debbie Cohen; Christoph Degenhart; Jaap Deinum; Evelyn Fischer; Richard Gordon; Ralph Kickuth; Gregory Kline; Andre Lacroix; Steven Magill; Diego Miotto; Mitsuhide Naruse; Tetsuo Nishikawa; Masao Omura; Eduardo Pimenta; Pierre-François Plouin; Marcus Quinkler; Martin Reincke; Ermanno Rossi; Lars Christian Rump; Fumitoshi Satoh; Leo Schultze Kool; Teresa Maria Seccia; Michael Stowasser; Akiyo Tanabe; Scott Trerotola; Oliver Vonend; Jiri Widimsky; Kwan-Dun Wu; Vin-Cent Wu; Achille Cesare Pessina Journal: J Clin Endocrinol Metab Date: 2012-03-07 Impact factor: 5.958
Authors: Oliver Vonend; Nora Ockenfels; Xing Gao; Bruno Allolio; Katharina Lang; Knut Mai; Ivo Quack; Andreas Saleh; Christoph Degenhart; Jochen Seufert; Lysann Seiler; Felix Beuschlein; Marcus Quinkler; Petr Podrabsky; Martin Bidlingmaier; Reinhard Lorenz; Martin Reincke; Lars Christian Rump Journal: Hypertension Date: 2011-03-07 Impact factor: 10.190
Authors: Min-On Tan; Troy Hai Kiat Puar; Saravana Kumar Swaminathan; Yu-Kwang Donovan Tay; Tar Choon Aw; David Yurui Lim; Haiyuan Shi; Lily Mae Quevedo Dacay; Meifen Zhang; Joan Joo Ching Khoo; Keng Sin Ng Journal: Singapore Med J Date: 2020-12-02 Impact factor: 3.331
Authors: Clemens Spink; Maxim Avanesov; Alexander Lenz; Frank Oliver Henes; Lennart Well; Thomas Schmidt; Gerhard Adam; Harald Ittrich; Peter Bannas Journal: Sci Rep Date: 2022-04-12 Impact factor: 4.379