{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T02:25:06Z","timestamp":1772504706502,"version":"3.50.1"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rofo"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:p>\n            Purpose\u2002To determine radiation exposure associated with adrenal vein sampling and its reduction by implementing the rapid cortisol assay and modification of the sampling protocol.<\/jats:p><jats:p>\n            Materials and Methods\u2002A single-center retrospective study of adrenal vein sampling performed between August 2009 and March 2020 revealed data from 151 procedures. Three subgroups were determined. In group I, a sampling protocol including sampling from the renal veins without the rapid cortisol assay was applied. In group II, blood was sampled using the same protocol but applying the rapid cortisol assay. In group III, a modified sampling protocol was used, in which the additional sampling from the renal veins was dispensed with, while the rapid cortisol assay was retained. Primary endpoints were radiation exposure parameters with dose area product, fluoroscopy time, and effective dose. As secondary endpoints, procedural data including technical success, lateralization, the correlation between patient BMI and radiation exposure, and concordance of lateralization with cross-sectional imaging were investigated. Furthermore, the correlation of aldosterone-cortisol ratios between the adrenal and ipsilateral renal vein was calculated to assess the benefit of sampling from the renal veins.<\/jats:p><jats:p>\n            Results\u2002For all procedures performed in the study collective, the median dose area product was 60.01 Gy*cm2 (5.71\u2013789.31), the median fluoroscopy time was 14.90\u200amin (3.27\u201380.90), and the calculated median effective dose was 12.60\u200amSv (1.20\u2013165.76). Significant differences in radiation exposure parameters between the study subgroups could be revealed. Dose area product resulted in reductions of 57.94\u200a% after implementation of the rapid cortisol assay and a further 40.44\u200a% after revision of the sampling protocol. Fluoroscopy time was reduced by 40.48\u200a% after integration of the rapid cortisol assay and a further 40.47\u200a% after protocol refinement. Radiation doses were increased in cases of resampling (dose area product 51.31 vs. 118.11 Gy*cm2, fluoroscopy time of 12.48 vs. 28.70\u200amin). A strong correlation between patient BMI and procedural dose area product could be found. After the introduction of the rapid cortisol assay, successive improvement of the technical success rate could be found (33.33\u200a% in group I, 90.22\u200a% in group II and 92.11\u200a% in group III). The correlation of aldosterone-cortisol ratios between adrenal and renal veins was poor.<\/jats:p><jats:p>\n            Conclusion\u2002The introduction of the rapid cortisol assay significantly decreased the radiation exposure and increased the technical success rate. Renal vein sampling did not provide further benefit in the evaluation of primary aldosteronism subtype and its omission resulted in a further reduction of radiation dose.<\/jats:p><jats:p>\n            Key Points:\n          <\/jats:p><jats:p>\n            Citation Format\n          <\/jats:p>","DOI":"10.1055\/a-1535-2566","type":"journal-article","created":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T22:59:10Z","timestamp":1628809150000},"page":"1392-1402","source":"Crossref","is-referenced-by-count":9,"title":["Reduction of Radiation Exposure in Adrenal Vein Sampling: Impact of the Rapid Cortisol Assay"],"prefix":"10.1055","volume":"193","author":[{"given":"Anne Marie","family":"Augustin","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Dalla Torre","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmina Teresa","family":"Fuss","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Fassnacht","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten Alexander","family":"Bley","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph","family":"Kickuth","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1161\/HYPERTENSIONAHA.113.02097","article-title":"An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism","volume":"63","author":"G P Rossi","year":"2014","journal-title":"Hypertension"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1210\/jc.2015-4061","article-title":"The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline","volume":"101","author":"J W 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Roentgenol"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1530\/EJE-11-0287","article-title":"Adrenal vein sampling using rapid cortisol assays in primary aldosteronism is useful in centers with low success rates","volume":"165","author":"M J Betz","year":"2011","journal-title":"Eur J Endocrinol"},{"issue":"S 01","key":"ref22","doi-asserted-by":"crossref","first-page":"S143","DOI":"10.1148\/rg.25si055514","article-title":"Adrenal vein sampling: how to make it quick, easy, and successful","volume":"25","author":"N Daunt","year":"2005","journal-title":"Radiographics"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1007\/s00268-017-4327-6","article-title":"A Multi-institutional Comparison of Adrenal Venous Sampling in Patients with Primary Aldosteronism: Caution Advised if Successful Bilateral Adrenal Vein Sampling is Not Achieved","volume":"42","author":"T S Wang","year":"2018","journal-title":"World J 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Gosch","year":"2007","journal-title":"Rofo"},{"issue":"04","key":"ref33","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1148\/radiographics.21.4.g01jl271033","article-title":"Fluoroscopy: patient radiation exposure issues","volume":"21","author":"M Mahesh","year":"2001","journal-title":"Radiographics"}],"container-title":["R\u00f6Fo - Fortschritte auf dem Gebiet der R\u00f6ntgenstrahlen und der bildgebenden Verfahren"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1535-2566.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T23:37:07Z","timestamp":1637710627000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1535-2566"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,12]]},"references-count":33,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,11,23]]},"published-print":{"date-parts":[[2021,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1535-2566","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1438-9029","1438-9010"],"issn-type":[{"value":"1438-9029","type":"print"},{"value":"1438-9010","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,12]]}}}