Node‐by‐node diagnosis for multiple ipsilateral nodules by segmental adrenal venous sampling in primary aldosteronism
Authors' conclusion
The sAVS could correctly diagnose the aldosterone production in multiple ipsilateral adrenal nodules.
Study context
- Population
- Patients with PA who underwent adrenalectomy following segmental adrenal venous sampling (sAVS)
- Participants
- 162 patients
- Outcome
- Pathological diagnosis and node-by-node diagnostic capability of sAVS in multiple ipsilateral nodules
Main finding
As reported in the abstract
Node-by-node diagnosis by sAVS in patients with multiple ipsilateral nodules
- Patients with two to three nodules on surgical side
- 11 (6.8%)
- PPV of most suspected aldosterone-producing adenoma (APA) (drainer with highest aldosterone by sAVS)
- 11/11 (100%, 95% CI: 71.5%-100%)
- PPV of second and third suspected APA
- 3/7 (42.9%, 95% CI: 9.9%-81.6%)
- PPV most suspected vs second/third suspected APA, significantly different
- p = .01
- PPV of non-APA
- 4/4 (100%, 95% CI: 39.8%-100%)
Observational data: associations, not effects.
Further findings
Diagnoses in patients with multiple nodules
Patients
- Lateralization index ≥4 after ACTH stimulation
- 7
- Two or three CYP11B2-positive APAs
- 2
- Both APAs and non-APAs
- 9
- All diagnosed by sAVS with ≥1 APA
Original publication
Node‐by‐node diagnosis for multiple ipsilateral nodules by segmental adrenal venous sampling in primary aldosteronism. Clin Endocrinol (Oxf). Published 21 December 2022. doi:10.
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