{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T16:45:43Z","timestamp":1783183543671,"version":"3.54.6"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T00:00:00Z","timestamp":1671580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>In patients with primary aldosteronism (PA), multiple adrenocortical nodules may be present on the surgical side. The aim of this study was to clarify the pathological diagnosis and the node\u2010by\u2010node diagnostic capability of segmental adrenal venous sampling (sAVS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>A total of 162 patients who underwent adrenalectomy following sAVS were studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Multiple nodules on the surgical side were extracted while referring to contrast\u2010enhanced computed tomography images. We also performed a detailed histopathological analysis of the resected specimens from patients undergoing sAVS, which included immunohistochemistry for CYP11B2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 11 (6.8%) patients, two to three nodules were detected on the surgical side. All patients were diagnosed by sAVS with at least one aldosterone\u2010producing adenoma (APA) for localized aldosterone elevation in tributaries. Seven patients showed a lateralization index value of \u22654 after ACTH stimulation. Histopathologically and clinically, two patients had two or three CYP11B2\u2010positive APAs, and the other nine patients both APAs and non\u2010APAs. The positive predictive value of the most suspected APA, that is, the drainer that showed the highest aldosterone level by sAVS, was 11\/11 (100%, 95% confidence interval [CI]: 71.5%\u2013100%), while that for the second and third suspected APA was 3\/7 (42.9%, 95% CI: 9.9%\u201381.6%), and they were significantly different (<jats:italic>p<\/jats:italic>\u2009=\u2009.01). Further, the positive predictive value of non\u2010APA was 4\/4 (100%, 95% CI: 39.8%\u2013100%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The sAVS could correctly diagnose the aldosterone production in multiple ipsilateral adrenal nodules.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14858","type":"journal-article","created":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T05:28:46Z","timestamp":1670304526000},"page":"487-495","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Node\u2010by\u2010node diagnosis for multiple ipsilateral nodules by segmental adrenal venous sampling in primary aldosteronism"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6869-2224","authenticated-orcid":false,"given":"Hiromitsu","family":"Tannai","sequence":"first","affiliation":[{"name":"Department of Radiology Yokohama Rosai Hospital Yokohama 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of Pathology Yokohama Rosai Hospital Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironobu","family":"Sasano","sequence":"additional","affiliation":[{"name":"Department of Pathology Tohoku University Graduate School of Medicine Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"Endocrinology and Diabetes Center Yokohama Rosai Hospital Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-4061"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ21-0508"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-14-1161"},{"issue":"127","key":"e_1_2_8_5_1","article-title":"A novel method: super\u2010selective adrenal venous 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