{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:21:46Z","timestamp":1765887706572},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,7,17]],"date-time":"2015-07-17T00:00:00Z","timestamp":1437091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Adrenal venous sampling (AVS) is the definitive evaluation for primary aldosteronism (PA). Pre\u2010AVS cross\u2010sectional imaging does not reduce the need for AVS. The goal of this study was to examine whether performing AVS prior to imaging could decrease the use of imaging in the evaluation of PA at a high volume, experienced center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective analysis of all AVS procedures (n\u2009=\u2009337) done for PA from 2001\u20132013. Patients whose cross\u2010sectional imaging reports were unavailable (n\u2009=\u200990) or AVS was non\u2010diagnostic (n\u2009=\u200912) were excluded. AVS was performed using modified Mayo technique. Univariate analysis utilized the \u03c7<jats:sup>2<\/jats:sup> test and fisher's exact test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 235 patients analyzed, 63% (n\u2009=\u2009148) were male. The mean age was 55\u2009\u00b1\u200911 years. AVS was non\u2010lateralizing in 43% (n\u2009=\u2009101); these patients might have avoided imaging with an AVS\u2010first approach. Imaging and AVS were concordant in 52% (n\u2009=\u2009123). In patients \u226440yo (n\u2009=\u200923), 35% (n\u2009=\u20098) had no lateralization on AVS, and might have avoided imaging in an AVS\u2010first approach. Imaging and AVS were concordant in 52% (n\u2009=\u200912) of patients \u226440yo, versus 52% (n\u2009=\u2009111) of patients &gt;40yo (<jats:italic>P<\/jats:italic>\u2009=\u20090.987).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An AVS\u2010first, imaging\u2010second approach could have avoided CT\/MRI in 43% of patients. At a high volume, experienced center, performing AVS first on patients with PA may reduce unnecessary cross\u2010sectional imaging studies. <jats:italic>J. Surg. Oncol. 2015 111:144\u2013148<\/jats:italic>. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.23963","type":"journal-article","created":{"date-parts":[[2015,7,17]],"date-time":"2015-07-17T16:08:55Z","timestamp":1437149335000},"page":"144-148","source":"Crossref","is-referenced-by-count":11,"title":["Reversing the established order: Should adrenal venous sampling precede cross\u2010sectional imaging in the evaluation of primary aldosteronism?"],"prefix":"10.1002","volume":"112","author":[{"given":"Melissa","family":"Asmar","sequence":"first","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Wachtel","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Yan","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas L.","family":"Fraker","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debbie","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Renal, Electrolyte and Hypertension Division Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott O.","family":"Trerotola","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Vascular and Interventional Radiology Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,7,17]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"Vital signs: Prevalence treatment and control of hypertension\u2010United States 1999\u20132002 and 2005\u20132008. 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