The Utility of Plasma Metanephrines to Optimise Adrenal Vein Sampling for Primary Aldosteronism: A Single Centre Experience
Authors' conclusion
Our findings demonstrate that incorporating MN measurements significantly enhances the accuracy of AVS interpretations, particularly in cases of cortisol co-secretion, thereby minimising diagnostic errors and optimising treatment strategies. This study supports the use of MN as reliable analytes to improve the diagnostic accuracy of AVS.
Study context
- Population
- Patients with confirmed primary aldosteronism (PA) undergoing adrenal vein sampling (AVS)
- Participants
- 129 patients132 AVS procedures
- Comparison
- Plasma metanephrines (MN) vs cortisol for AVS cannulation success and lateralisation
- Outcome
- Diagnostic performance of MN-based SI (cannulation success) and LI (unilateral disease)
Methodological detailssingle-centre, single operator, unstimulated AVS
- Single-centre
- Single operator
- Unstimulated AVS
Performance
As reported in the abstract
| Test or model | Cut-off | Sensitivity | Specificity |
|---|---|---|---|
| MN selectivity index (SI) | >3 | 99% | 100% |
| Aldosterone/MN lateralisation index (LI) | >4 | 94% | 96% |
Cut-off
MN selectivity index (SI)>3
Aldosterone/MN lateralisation index (LI)>4
Sensitivity
MN selectivity index (SI)99%
Aldosterone/MN lateralisation index (LI)94%
Specificity
MN selectivity index (SI)100%
Aldosterone/MN lateralisation index (LI)96%
Original publication
The Utility of Plasma Metanephrines to Optimise Adrenal Vein Sampling for Primary Aldosteronism: A Single Centre Experience. Clin Endocrinol (Oxf). Published 19 May 2025. doi:10.
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