Key result
Discordance between adrenal cross-sectional imaging and adrenal vein sampling in primary aldosteronism was high (22% to 28%) and positively correlated with lateralization index threshold stringency (P<0.001).
Why the study?
Subtyping of primary aldosteronism using imaging and AVS may yield discordant results, and interpretation criteria for AVS lateralization may affect these discordance rates.
Does adrenal cross-sectional imaging accurately predict lateralization compared to adrenal vein sampling in patients with primary aldosteronism?
Population
342 consecutive patients with primary aldosteronism undergoing AVS at a quaternary care center
Comparison
Adrenal cross-sectional imaging vs AVS lateralization across varying LI thresholds
Design
Retrospective cohort study
Authors
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Discordance rates of 22-28% between imaging and AVS in PA warrant caution relying on imaging alone; leaves open optimal AVS thresholds.
Cohort (n=342)
No
Does adrenal cross-sectional imaging accurately predict lateralization compared to adrenal vein sampling in patients with primary aldosteronism?
p-value: p=<0.001
Discordance between cross-sectional imaging and adrenal vein sampling in primary aldosteronism exceeds 20%, suggesting imaging alone is insufficient for surgical decision-making.
Sam et al. (2018) conducted a cohort in Primary aldosteronism (n=342). Adrenal cross-sectional imaging vs. Adrenal vein sampling (AVS) was evaluated on Discordance between imaging and AVS (p=<0.001). Discordance between adrenal cross-sectional imaging and adrenal vein sampling in primary aldosteronism was high (22% to 28%) and positively correlated with lateralization index threshold stringency (P<0.001).
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