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This retrospective study compared liquid chromatography-tandem mass spectrometry (LC-MS/MS) with RIA in AVS and assessed surgical decision outcomes using primary aldosteronism surgical criteria. Among 230 patients, LC-MS/MS correlated with RIA PAC yet showed higher unilateral detection and better identification of complete clinical success after adrenalectomy when decisions used LC-MS/MS lateralization.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/liquid-chromatography-tandem-mass-spectrometry-outperforms-radioimmunoassay-in-guiding-surgical-decisions-based-on-adrenal-venous-sampling-in-primary-aldosteronism/433981/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/liquid-chromatography-tandem-mass-spectrometry-outperforms-radioimmunoassay-in-guiding-surgical-decisions-based-on-adrenal-venous-sampling-in-primary-aldosteronism/433981.png","ImageObject",300,407,{"name":42,"@type":43},"Rowan","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-06","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why is adrenal venous sampling important in primary aldosteronism?","Question",{"text":63,"@type":64},"AVS is essential to determine whether aldosterone excess is unilateral or bilateral, which guides whether surgery or medical therapy is appropriate.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How does LC-MS/MS compare with RIA in measuring plasma aldosterone concentration?",{"text":68,"@type":64},"LC-MS/MS showed significant correlations with RIA-measured plasma aldosterone concentration under both unstimulated and stimulated AVS conditions.",{"name":70,"@type":61,"acceptedAnswer":71},"What impact did switching to LC-MS/MS-based lateralization have on surgical outcomes?",{"text":72,"@type":64},"When surgical decisions were based on LC-MS/MS lateralization, patients achieved higher rates of complete clinical success after adrenalectomy, with improved identification particularly under stimulated 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2025;40:1002-1011 [https://doi.org/10.3803/EnM.2024.2237](https://doi.org/10.3803/EnM.2024.2237)[ ](https://doi.org/10.3803/EnM.2024.2237)[pISSN 2093-596X](pISSN 2093-596X) · eISSN 2093-5978  \nLiquid Chromatography-Tandem Mass Spectrometry Outperforms Radioimmunoassay in Guiding Surgical Decisions Based on Adrenal Venous Sampling in Primary Aldosteronism  \nBo-Ching Lee1,2, Chien-Wei Huang3,4, Chin-Chen Chang1,5, Guan-Yuan Chen5, Jia-Zheng Huang 1, Pin-Chen Chen1, Te-I Weng5, Kao-Lang Liu1, Vin-Cent Wu6, Yen-Hung Lin6, on Behalf of the TAIPAI Study Group  \n1Department of Medical Imaging, National Taiwan University Hospital, National Taiwan University College of Medicine; 2Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei; 3Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung; 4School of Medicine, National Yang Ming Chiao Tung University; 5Department and Graduate Institute of Forensic Medicine, National Taiwan University College of Medicine; 6Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan  \nBackground: 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) inAVS and its impact on clinical outcomes.  \nMethods: 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.  \nResults: LC-MS/MS showed significant correlations with PAC levels measured by RIA inAVS (r = 0.40 [unstimulated] and r = 0.56 [stimulated]; both P\u003C0.001). 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\u003C0.001) and stimulated conditions (36.4% vs. 9.7%, P\u003C0.001) . 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.  \nConclusion: 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.  \n\n| Keywords: Adrenal venous sampling; Hyperaldosteronism; Humans; Mass spectrometry |  |\n| --- | --- |\n| Received: 6 November 2024, Revised: 6 April 2025, Accepted: 23 April 2025\u003Cbr>Corresponding author: Chin-Chen Chang\u003Cbr>Department of Medical Imaging, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100225, Taiwan\u003Cbr>Tel: +886-2-23123456, Fax: +886-2-2322-4552, [E-mail:](E-mail: macotocc@gmail.com)[ macotocc@gmail.com](E-mail: macotocc@gmail.com) | Copyright © 2025 Korean Endocrine Society\u003Cbr>This is an Open Access article distributed under the terms of\u003Cbr>the Creative Commons Attribution Non-Commercial License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.\u003Cbr>|\n\n1002 [www.e-enm.org](www.e-enm.org)  \nLC-MS/MS Analysis forAVS  \nINTRODUCTION  \nPrimary aldosteronism (PA), characterized by excessive aldosterone secreti","cbCairPg3DlbE8Br","https://ap.wps.com/l/cbCairPg3DlbE8Br","pdf",583052,14,"English","# Background\n# Methods\n## Patient enrollment\n# Results\n# Conclusion\n# Introduction","[{\"question\":\"Why is adrenal venous sampling important in primary aldosteronism?\",\"answer\":\"AVS is essential to determine whether aldosterone excess is unilateral or bilateral, which guides whether surgery or medical therapy is appropriate.\"},{\"question\":\"How does LC-MS/MS compare with RIA in measuring plasma aldosterone concentration?\",\"answer\":\"LC-MS/MS showed significant correlations with RIA-measured plasma aldosterone concentration under both unstimulated and stimulated AVS conditions.\"},{\"question\":\"What impact did switching to LC-MS/MS-based lateralization have on surgical outcomes?\",\"answer\":\"When surgical decisions were based on LC-MS/MS lateralization, patients achieved higher rates of complete clinical success after adrenalectomy, with improved identification particularly under stimulated conditions.\"}]","Liquid Chromatography-Tandem Mass Spectrometry Outperforms Radioimmunoassay in Guiding Surgical Decisions Based on Adrenal Venous Sampling in Primary Aldosteronism | PDF",1790666463,35]