Warning: fopen(/home/virtual/enm-kes/journal/upload/ip_log/ip_log_2025-07.txt): failed to open stream: Permission denied in /home/virtual/lib/view_data.php on line 100 Warning: fwrite() expects parameter 1 to be resource, boolean given in /home/virtual/lib/view_data.php on line 101 Liquid Chromatography-Tandem Mass Spectrometry Outperforms Radioimmunoassay in Guiding Surgical Decisions Based on Adrenal Venous Sampling in Primary Aldosteronism
Skip Navigation
Skip to contents

Endocrinol Metab : Endocrinology and Metabolism

clarivate
OPEN ACCESS
SEARCH
Search
Advanced Search
mobile menu button

Articles

Page Path
HOME > Endocrinol Metab > Ahead-of print > Article
Original Article Liquid Chromatography-Tandem Mass Spectrometry Outperforms Radioimmunoassay in Guiding Surgical Decisions Based on Adrenal Venous Sampling in Primary Aldosteronism
Bo-Ching Lee1,2orcid , Chien-Wei Huang3,4, Chin-Chen Chang1,5orcid , Guan-Yuan Chen5, Jia-Zheng Huang1, Pin-Chen Chen1, Te-I Weng5, Kao-Lang Liu1, Vin-Cent Wu6, Yen-Hung Lin6, on Behalf of the TAIPAI Study Group

DOI: https://doi.org/10.3803/EnM.2024.2237 [Epub ahead of print]
Published online: July 1, 2025
  • 170 Views
  • 14 Download
  • 0 Crossref
  • 0 Scopus
1Department of Medical Imaging, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
2Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
3Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
4School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
5Department and Graduate Institute of Forensic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
6Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
Corresponding author:  Chin-Chen Chang, Tel: +886-2-23123456, Fax: +886-2-2322-4552, 
Email: macotocc@gmail.com
Received: 6 November 2024   • Revised: 6 April 2025   • Accepted: 23 April 2025
Full Article

Download PDF Download PDF

Abstract

Background
Adrenal venous sampling (AVS) is essential for diagnosing unilateral aldosterone oversecretion in primary aldosteronism (PA). Traditionally, AVS relies on radioimmunoassay (RIA) to measure plasma aldosterone concentration (PAC), although RIA has limited specificity and considerable variability. This study evaluated the role of liquid chromatography-tandem mass spectrometry (LC-MS/MS) in AVS and its impact on clinical outcomes.
Methods
Among 230 patients with PA (May 2020 to April 2023) who underwent AVS, successful sampling was achieved in 182 patients (79.1%) under unstimulated conditions and 206 patients (89.6%) under stimulated conditions. PAC levels from peripheral and adrenal veins measured by LC-MS/MS were compared with RIA results. Patient outcomes were categorized according to the Primary Aldosteronism Surgical Outcomes criteria.
Results
LC-MS/MS showed significant correlations with PAC levels measured by RIA in AVS (r=0.40 [unstimulated] and r=0.56 [stimulated]; both P<0.001). However, lateralization concordance between RIA and LC-MS/MS was moderate, at only 57.7% (unstimulated) and 64.6% (stimulated). LC-MS/MS identified more unilateral disease than RIA under both unstimulated (61.5% vs. 37.4%, P<0.001) and stimulated conditions (36.4% vs. 9.7%, P<0.001). Patients achieving complete clinical success after adrenalectomy were more accurately identified by LC-MS/MS than RIA under stimulated (55.6% vs. 22.2%, P=0.035), but not in unstimulated conditions.
Conclusion
LC-MS/MS outperformed RIA in identifying unilateral disease, resulting in higher rates of complete clinical success in adrenalectomy patients when surgical decisions were based on LC-MS/MS lateralization results.

Related articles
Endocrinol Metab : Endocrinology and Metabolism
© Korean Endocrine Society.
TOP