Clinical utility of adrenal venous sampling for functional lateralization in adrenocorticotropic hormone (ACTH)-independent autonomous cortisol secretion: relevance in non-decisive imaging
Authors' conclusion
In patients with bilateral or non-decisive CT findings, AVS frequently identified surgically remediable unilateral cortisol secretion that would not have been recognized by imaging alone.
Study context
- Population
- Patients with ACTH-independent autonomous cortisol secretion and bilateral or non-decisive adrenal imaging who underwent successful adrenal venous sampling (AVS) (contrast-enhanced computed tomography (CT), adosterol scintigraphy, AVS under low-dose dexamethasone suppression without exogenous ACTH stimulation), April 2016–October 2025of 66 identified
- Participants
- 21 patients
- Outcome
- Unilateral cortisol secretion identified by AVS
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
AVS identified unilateral cortisol secretion
11
52%
Postoperative remission confirmed among AVS-lateralized patients
9 of these 11 patients
82%
Observational data: associations, not effects.
Further findings
CT adrenal size predictors of AVS-defined lateralization
- Adrenal size difference on CT did not predict lateralization: 2.0 mm vs 1.5 mm; P = .59
- Adrenal size ratio on CT did not predict lateralization: 1.11 vs 1.10; P = .48
Durability of remission · median follow-up 4.0 years (range, 1.6-7.0 years)
- Remission status remained unchanged throughout follow-up
Original publication
Clinical utility of adrenal venous sampling for functional lateralization in ACTH-independent autonomous cortisol secretion: relevance in non-decisive imaging. Eur J Endocrinol. Published 5 August 2026. doi:10.
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