The where, who and how of adrenal vein sampling in Australia and New Zealand

Introduction Primary aldosteronism (PA) causes 10–15% of cases of hypertension, and it is increasingly recognised as being under‐diagnosed. An interventional radiology procedure, adrenal vein sampling (AVS), is a necessary and important diagnostic procedure for complete workup of PA. There is an ant...

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Bibliographic Details
Published in:Journal of medical imaging and radiation oncology 2024-02, Vol.68 (1), p.87-93
Main Authors: Ng, Elisabeth, Chong, Winston, Lau, Kenneth K, Gwini, Stella May, Carroll, Richard W, Doery, James CG, Fuller, Peter J, Yang, Jun
Format: Article
Language:English
Subjects:
adrenal vein sampling
endocrine hypertension
Endocrinology
Heterogeneity
Hypertension
interventional radiology
primary aldosteronism
Sampling
venous sampling
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Summary:Introduction Primary aldosteronism (PA) causes 10–15% of cases of hypertension, and it is increasingly recognised as being under‐diagnosed. An interventional radiology procedure, adrenal vein sampling (AVS), is a necessary and important diagnostic procedure for complete workup of PA. There is an anticipated increase in demand for AVS as detection of PA improves. This study aims to describe the current landscape of AVS in Australia and New Zealand (NZ). Methods Two surveys exploring AVS methodology and performance were conducted of (i) Endocrinology Unit Heads and (ii) interventional radiologists who perform AVS, at public hospitals with Endocrinology Units across Australia and NZ. Results Responses were received from 48/53 Endocrinology Unit Heads (91%) and 35 radiologists from 26 sites (87% of AVS sites). AVS was provided at 28/48 Endocrinology sites (58%) across Australia and NZ. In Australia, sites were concentrated in Victoria, New South Wales and Queensland with none in the Northern Territory; in NZ, sites were more evenly distributed across the North and South Islands. AVS was performed by 1–2 dedicated radiologists at 24 sites, 2–3 radiologists at two sites and a rotating roster of radiologists at two sites. Responses to both surveys revealed significant variation in AVS methodology and interpretation of AVS results. Conclusion There is significant heterogeneity in the availability of AVS, the procedural details and the interpretation of results across Australia and NZ, which potentially impacts the quality of patient care and ability to scale up AVS capacity to meet increasing demand.
ISSN:1754-9477
1754-9485
DOI:10.1111/1754-9485.13573