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Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism

CONTEXT: In patients with primary aldosteronism (PA), it remains unclear whether aldosterone-producing adenomas are likely to develop in the left or right adrenal gland. OBJECTIVE: To investigate left-right differences of PA laterality diagnoses via CT imaging and adrenal vein sampling (AVS). DESIGN...

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Autores principales: Wada, Norio, Shibayama, Yui, Yoneda, Takashi, Katabami, Takuyuki, Kurihara, Isao, Tsuiki, Mika, Ichijo, Takamasa, Ogawa, Yoshihiro, Kawashima, Junji, Sone, Masakatsu, Yoshimoto, Takanobu, Matsuda, Yuichi, Fujita, Megumi, Kobayashi, Hiroki, Tamura, Kouichi, Kamemura, Kohei, Otsuki, Michio, Okamura, Shintaro, Naruse, Mitsuhide
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Endocrine Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6608550/
https://www.ncbi.nlm.nih.gov/pubmed/31286105
http://dx.doi.org/10.1210/js.2019-00131
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author Wada, Norio
Shibayama, Yui
Yoneda, Takashi
Katabami, Takuyuki
Kurihara, Isao
Tsuiki, Mika
Ichijo, Takamasa
Ogawa, Yoshihiro
Kawashima, Junji
Sone, Masakatsu
Yoshimoto, Takanobu
Matsuda, Yuichi
Fujita, Megumi
Kobayashi, Hiroki
Tamura, Kouichi
Kamemura, Kohei
Otsuki, Michio
Okamura, Shintaro
Naruse, Mitsuhide
author_facet Wada, Norio
Shibayama, Yui
Yoneda, Takashi
Katabami, Takuyuki
Kurihara, Isao
Tsuiki, Mika
Ichijo, Takamasa
Ogawa, Yoshihiro
Kawashima, Junji
Sone, Masakatsu
Yoshimoto, Takanobu
Matsuda, Yuichi
Fujita, Megumi
Kobayashi, Hiroki
Tamura, Kouichi
Kamemura, Kohei
Otsuki, Michio
Okamura, Shintaro
Naruse, Mitsuhide
author_sort Wada, Norio
collection PubMed
description CONTEXT: In patients with primary aldosteronism (PA), it remains unclear whether aldosterone-producing adenomas are likely to develop in the left or right adrenal gland. OBJECTIVE: To investigate left-right differences of PA laterality diagnoses via CT imaging and adrenal vein sampling (AVS). DESIGN: Retrospective, observational study. PATIENTS: From the Japan Primary Aldosteronism Study, 1493 patients with PA were enrolled who underwent CT and ACTH-stimulated AVS. MEASUREMENTS: Left or right adrenal nodular lesion distribution and laterality observed on CT scans and from AVS were noted. RESULTS: Both on CT scans and AVS, unilateral results were observed more frequently on the left side than on the right side (25.1% vs 15.4% and 17.3% vs 13.5%, respectively; P < 0.01for both diagnostic techniques). There was no significant difference in the concordance rate for CT and AVS between patients with left and right unilateral nodular lesions observed on CT scans (44.1% and 50.9%, respectively; P = 0.15). In patients with nodules <20 mm, the concordance rate was significantly greater on the right side than the left side (45.8% vs 56.4%; P = 0.03). In patients with bilateral results of AVS, unilateral nodular lesions were detected more frequently on the left side than the right side (17.8% vs 9.4%; P < 0.01). CONCLUSION: These results suggest aldosterone-producing adenomas and nonfunctioning tumors are more likely to develop on the left side in patients with PA and that misdiagnosis of CT-based lateralization may occur more frequently on the left side.
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spelling pubmed-66085502019-07-08 Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism Wada, Norio Shibayama, Yui Yoneda, Takashi Katabami, Takuyuki Kurihara, Isao Tsuiki, Mika Ichijo, Takamasa Ogawa, Yoshihiro Kawashima, Junji Sone, Masakatsu Yoshimoto, Takanobu Matsuda, Yuichi Fujita, Megumi Kobayashi, Hiroki Tamura, Kouichi Kamemura, Kohei Otsuki, Michio Okamura, Shintaro Naruse, Mitsuhide J Endocr Soc Clinical Research Articles CONTEXT: In patients with primary aldosteronism (PA), it remains unclear whether aldosterone-producing adenomas are likely to develop in the left or right adrenal gland. OBJECTIVE: To investigate left-right differences of PA laterality diagnoses via CT imaging and adrenal vein sampling (AVS). DESIGN: Retrospective, observational study. PATIENTS: From the Japan Primary Aldosteronism Study, 1493 patients with PA were enrolled who underwent CT and ACTH-stimulated AVS. MEASUREMENTS: Left or right adrenal nodular lesion distribution and laterality observed on CT scans and from AVS were noted. RESULTS: Both on CT scans and AVS, unilateral results were observed more frequently on the left side than on the right side (25.1% vs 15.4% and 17.3% vs 13.5%, respectively; P < 0.01for both diagnostic techniques). There was no significant difference in the concordance rate for CT and AVS between patients with left and right unilateral nodular lesions observed on CT scans (44.1% and 50.9%, respectively; P = 0.15). In patients with nodules <20 mm, the concordance rate was significantly greater on the right side than the left side (45.8% vs 56.4%; P = 0.03). In patients with bilateral results of AVS, unilateral nodular lesions were detected more frequently on the left side than the right side (17.8% vs 9.4%; P < 0.01). CONCLUSION: These results suggest aldosterone-producing adenomas and nonfunctioning tumors are more likely to develop on the left side in patients with PA and that misdiagnosis of CT-based lateralization may occur more frequently on the left side. Endocrine Society 2019-05-16 /pmc/articles/PMC6608550/ /pubmed/31286105 http://dx.doi.org/10.1210/js.2019-00131 Text en Copyright © 2019 Endocrine Society https://creativecommons.org/licenses/by-nc-nd/4.0/ This article has been published under the terms of the Creative Commons Attribution Non-Commercial, No-Derivatives License (CC BY-NC-ND; https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Research Articles
Wada, Norio
Shibayama, Yui
Yoneda, Takashi
Katabami, Takuyuki
Kurihara, Isao
Tsuiki, Mika
Ichijo, Takamasa
Ogawa, Yoshihiro
Kawashima, Junji
Sone, Masakatsu
Yoshimoto, Takanobu
Matsuda, Yuichi
Fujita, Megumi
Kobayashi, Hiroki
Tamura, Kouichi
Kamemura, Kohei
Otsuki, Michio
Okamura, Shintaro
Naruse, Mitsuhide
Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism
title Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism
title_full Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism
title_fullStr Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism
title_full_unstemmed Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism
title_short Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism
title_sort lateralizing asymmetry of adrenal imaging and adrenal vein sampling in patients with primary aldosteronism
topic Clinical Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6608550/
https://www.ncbi.nlm.nih.gov/pubmed/31286105
http://dx.doi.org/10.1210/js.2019-00131
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