Comparison of C-arm Computed Tomography and On-site Quick Cortisol Assay for Adrenal Venous Sampling: A Retrospective Study of 178 Patients

Overview

Journal Eur Radiol

Specialty Radiology

Date 2017 Jul 6

PMID 28677050

Citations 14

Authors

Chin-Chen Chang

Bo-Ching Lee

Yeun-Chung Chang

Vin-Cent Wu

Kuo-How Huang

Kao-Lang Liu

Affiliations

Soon will be listed here.

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 (cortisol/cortisol) 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.

Citing Articles

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