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Comparison of C-arm computed tomography and on-site quick cortisol assay for adrenal venous sampling: A retrospective study of 178 patients.

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.

journal_name

Eur Radiol

journal_title

European radiology

authors

Chang CC,Lee BC,Chang YC,Wu VC,Huang KH,Liu KL,TAIPAI Study Group.

doi

10.1007/s00330-017-4930-9

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

5006-5014

issue

12

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-017-4930-9

journal_volume

27

pub_type

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