TY - JOUR
T1 - Volumetric evaluation of CT images of adrenal glands in primary aldosteronism
AU - for the SPARTACUS Investigators
AU - Velema, M. S.
AU - Canu, L.
AU - Dekkers, T.
AU - Hermus, A. R. M. M.
AU - Timmers, H. J.L.M.
AU - Schultze Kool, L. J.
AU - Groenewoud, H. J.M.M.
AU - Jacobs, C.
AU - Deinum, J.
AU - Prejbisz, A.
AU - Kool, L. J.S.
AU - Spiering, W.
AU - Kołodziejczyk-Kruk, S.
AU - Arntz, M.
AU - Kądziela, J.
AU - Langenhuijsen, J. F.
AU - Kerstens, M. N.
AU - van den Meiracker, A. H.
AU - van den Born, B. J.
AU - Sweep, F. C.G.J.
AU - Januszewicz, A.
AU - Ligthart-Naber, A. F.
AU - Makai, P.
AU - van der Wilt, G. J.
AU - Lenders, J. W.M.
N1 - Funding Information:
We thank Liën Coolen for her contribution to this study and Jacques Lenders for his comments on the manuscript. The members of for the SPARTACUS Investigators: T. Dekkers, A. Prejbisz, L. J. S. Kool, H. J. M. M. Groenewoud, M. Velema, W. Spiering, S. Kołodziejczyk-Kruk, M. Arntz, J. Kądziela, J. F. Langenhuijsen, M. N. Kerstens, A. H. van den Meiracker, B. J. van den Born, F. C. G. J. Sweep, A. R. M. M. Hermus, A. Januszewicz, A. F. Ligthart-Naber, P. Makai, G. J. van der Wilt, J. W. M. Lenders, J. Deinum.
Publisher Copyright:
© 2021, Italian Society of Endocrinology (SIE).
PY - 2021/11
Y1 - 2021/11
N2 - Objectives: To investigate whether adrenal volumetry provides better agreement with adrenal vein sampling (AVS) than conventional CT for subtyping PA. Furthermore, we evaluated whether the size of this contralateral adrenal was a prognostic factor for clinical outcome after unilateral adrenalectomy.Methods: We retrospectively analyzed volumes of both adrenal glands of the 180 CT-scans (88/180 with unilateral and 92/180 with bilateral disease) of the patients with PA included in the SPARTACUS trial of which 85 also had undergone an AVS. In addition, we examined CT-scans of 20 healthy individuals to compare adrenal volumes with published normal values.Results: Adrenal volume was higher for the left than the right adrenal (mean and SD: 6.49 ± 2.77 ml versus 5.25 ± 1.87 ml for the right adrenal; p < 0.001). Concordance between volumetry and AVS in subtyping was 58.8%, versus 51.8% between conventional CT results and AVS (p = NS). The volumes of the contralateral adrenals in the patients with unilateral disease (right 4.78 ± 1.37 ml; left 6.00 ± 2.73 ml) were higher than those of healthy controls reported in the literature (right 3.62 ± 1.23 ml p < 0.001; left 4.84 ± 1.67 ml p = 0.02). In a multivariable analysis the contralateral volume was not associated with biochemical or clinical success, nor with the defined daily doses of antihypertensive agents at 1 year follow-up.Conclusions: Volumetry of the adrenal glands is not superior to current assessment of adrenal size by CT for subtyping patients with PA. Furthermore, in patients with unilateral disease the size of the contralateral adrenal is enlarged but its size is not associated with outcome.
AB - Objectives: To investigate whether adrenal volumetry provides better agreement with adrenal vein sampling (AVS) than conventional CT for subtyping PA. Furthermore, we evaluated whether the size of this contralateral adrenal was a prognostic factor for clinical outcome after unilateral adrenalectomy.Methods: We retrospectively analyzed volumes of both adrenal glands of the 180 CT-scans (88/180 with unilateral and 92/180 with bilateral disease) of the patients with PA included in the SPARTACUS trial of which 85 also had undergone an AVS. In addition, we examined CT-scans of 20 healthy individuals to compare adrenal volumes with published normal values.Results: Adrenal volume was higher for the left than the right adrenal (mean and SD: 6.49 ± 2.77 ml versus 5.25 ± 1.87 ml for the right adrenal; p < 0.001). Concordance between volumetry and AVS in subtyping was 58.8%, versus 51.8% between conventional CT results and AVS (p = NS). The volumes of the contralateral adrenals in the patients with unilateral disease (right 4.78 ± 1.37 ml; left 6.00 ± 2.73 ml) were higher than those of healthy controls reported in the literature (right 3.62 ± 1.23 ml p < 0.001; left 4.84 ± 1.67 ml p = 0.02). In a multivariable analysis the contralateral volume was not associated with biochemical or clinical success, nor with the defined daily doses of antihypertensive agents at 1 year follow-up.Conclusions: Volumetry of the adrenal glands is not superior to current assessment of adrenal size by CT for subtyping patients with PA. Furthermore, in patients with unilateral disease the size of the contralateral adrenal is enlarged but its size is not associated with outcome.
KW - Adrenal gland neoplasms
KW - CT-scanning
KW - Diagnosis
KW - Hyperaldosteronism
KW - Primary aldosteronism
KW - Tomography
KW - X-ray computed
U2 - 10.1007/s40618-021-01540-5
DO - 10.1007/s40618-021-01540-5
M3 - Article
C2 - 33666874
AN - SCOPUS:85102205981
SN - 0391-4097
VL - 44
SP - 2359
EP - 2366
JO - Journal of endocrinological investigation
JF - Journal of endocrinological investigation
IS - 11
ER -