Journal of vascular and interventional radiology : JVIR · 2026
Contralateral Suppression Index as a Surrogate Marker for Aldosterone Lateralization in Simulated Incomplete Adrenal Vein Sampling.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Basson Derik J, Páez-Carpio Alfredo, Kalu Amos, Mughli Rawan Abu, Du Plessis Jacques, David Elizabeth, Pugash Robyn, Maroun Gilbert
Аннотация
PURPOSE: To evaluate the contralateral suppression index (CSI) as a diagnostic tool for predicting aldosterone lateralization under simulated incomplete adrenal vein sampling (AVS) and to assess the impact of adrenal nodules and age on its performance.
MATERIALS AND METHODS: This study retrospectively reviewed consecutive patients who underwent AVS for primary aldosteronism between January 1, 2016, and June 30, 2024. A total of 362 patients were analyzed. Bilaterally selective studies were reanalyzed by masking 1 adrenal side to simulate incomplete sampling. CSI was calculated from the available adrenal vein and inferior vena cava samples and tested across 3 thresholds (≥1.0, ≥0.5, and ≥0.2) using lateralization index (LI) ≥4.0 as the reference. Performance metrics included positive predictive value (PPV), sensitivity, and specificity, overall and stratified by adrenal nodules and age (<35 vs ≥35 years).
RESULTS: Mean CSI was 0.33 in lateralized cases (LI ≥ 4.0) and 3.16 in nonlateralized cases (P < .001). Without a concordant nodule, CSI ≤1 supported lateralization (PPV, 70%; sensitivity, 88%; specificity, 94%); stricter thresholds increased certainty, with CSI ≤0.5 yielding a PPV of 98% and specificity of 99% (sensitivity, 61%) and CSI ≤0.2 achieving a PPV and specificity of 100% (sensitivity, 28%). With a concordant nodule, PPVs were 94%, 99%, and 100% at CSIs ≤1, ≤0.5, and ≤0.2, respectively, with sensitivity of 98%-64% . Results were consistent across age groups.
CONCLUSIONS: CSI reliably predicted aldosterone lateralization under simulated incomplete AVS. Thresholds of ≤0.5 and ≤0.2 provided confirmatory accuracy, particularly when combined with concordant imaging.
MATERIALS AND METHODS: This study retrospectively reviewed consecutive patients who underwent AVS for primary aldosteronism between January 1, 2016, and June 30, 2024. A total of 362 patients were analyzed. Bilaterally selective studies were reanalyzed by masking 1 adrenal side to simulate incomplete sampling. CSI was calculated from the available adrenal vein and inferior vena cava samples and tested across 3 thresholds (≥1.0, ≥0.5, and ≥0.2) using lateralization index (LI) ≥4.0 as the reference. Performance metrics included positive predictive value (PPV), sensitivity, and specificity, overall and stratified by adrenal nodules and age (<35 vs ≥35 years).
RESULTS: Mean CSI was 0.33 in lateralized cases (LI ≥ 4.0) and 3.16 in nonlateralized cases (P < .001). Without a concordant nodule, CSI ≤1 supported lateralization (PPV, 70%; sensitivity, 88%; specificity, 94%); stricter thresholds increased certainty, with CSI ≤0.5 yielding a PPV of 98% and specificity of 99% (sensitivity, 61%) and CSI ≤0.2 achieving a PPV and specificity of 100% (sensitivity, 28%). With a concordant nodule, PPVs were 94%, 99%, and 100% at CSIs ≤1, ≤0.5, and ≤0.2, respectively, with sensitivity of 98%-64% . Results were consistent across age groups.
CONCLUSIONS: CSI reliably predicted aldosterone lateralization under simulated incomplete AVS. Thresholds of ≤0.5 and ≤0.2 provided confirmatory accuracy, particularly when combined with concordant imaging.