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Updated: Mar 23, 2026
A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Impact of New Quick Gold Nanoparticle-Based Cortisol Assay During Adrenal Vein Sampling for Primary Aldosteronism
Takashi Yoneda1, Shigehiro Karashima1, Mitsuhiro Kometani1
1Program Management Office for Paradigms-Establishing Centers for Fostering Medical Researchers of the Future (T.Y., M.K.), Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Division of Endocrinology and Hypertension (T.Y., S.K., M.K., M.U., R.O., Yoshim. Takeda, Yoshiyu Takeda), Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8640, Japan; Departments of Hygiene (M.D.) and Radiology (J.S., T.M., W.K., T.G.), Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; Department of Advanced Medical Imaging (O.M.), Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan; Department of Materials Science (K.I., Y.Taka.), School of Material Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa 923-1292, Japan; Department of Applied Physics (E.T.), Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan; Hoju Memorial Hospital (M.O., M.N.), Nomi, Ishikawa 923-1226, Japan; Takaoka Municipal Hospital (S.M., N.T.), Takaoka, Toyama 933-8550, Japan; Sanda Municipal Hospital (Y.M.), Sanda, Hyogo 669-1321, Japan; Akashi Medical Center (K.K.), Akashi, Hyogo 674-0063, Japan; Ishikawa Prefectural Hospital (S.F.), Kanazawa, Ishikawa 920-8530, Japan; Department of Endocrinology (T.Se., T.Sa.), Saisekai Ishikawa Hospital, Kanazawa, Ishikawa 920-0353, Japan; Division of Cardiology (K.H., M.Y.), Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa 920-8640, Japan; and Innovative Clinical Research Center (Yoshiyu Takeda), Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8640, Japan.
Context:
Adrenal vein sampling (AVS) is essential for identifying a surgically curable form of primary aldosteronism (PA), but accurate placement of the sampling catheter is technically challenging. Intraprocedural cortisol measurement can confirm the catheter's position, thereby increasing the AVS success rate.
Objective And Methods:
We developed a quick cortisol assay (QCA) that uses immunochromatography and gold nanoparticles and can be performed either semiquantitatively or quantitatively. The assay was evaluated in two studies. In a single-center study, PA patients were assigned to undergo AVS incorporating the semiquantitative QCA (n = 30), the quantitative QCA (n = 30), or without the QCA (n = 30), and the rates of successful AVS were determined. In a prospective multicenter randomized, controlled study, the success rates of AVS performed with (n = 148) or without (n = 145) the semiquantitative QCA were determined.
Results:
Cortisol concentrations were measured during AVS in 6 minutes or less in the radiology suite, without additional technical assistance, and significantly correlated with a conventional reference assay (R(2) = 0.994; P < .001). In the single-center study, the differences in the AVS success rates associated with semiquantitative and quantitative QCAs were not significant (both 93%); however, the success rates were significantly higher than the rate of successful AVS performed without using the QCA (63%; P < .001). The success rate of AVS performed in the multicenter study was 94% for the semiquantitative QCA, which was significantly higher than the rate for the patients without QCA (60%; P < .001).
Conclusions:
Our novel QCA was rapidly and easily performed at the point of care and improved the rate of successful AVS.
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