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Aldosterone/Cortisol Ratio, Adrenal Vein Sampling, 6 Sites
Test Code18826
CPT Codes
82088 (x6), 82533 (x6)
Includes
Aldosterone; Cortisol, Total; Aldosterone/Cortisol Ratio
Preferred Specimen
2 mL serum collected in each of six red-top tubes (no gel)
Minimum Volume
0.5 mL (x6)
Other Acceptable Specimens
Plasma collected in: Each of six EDTA (lavender-top) tubes
Instructions
For each timed specimen submitted, each tube must be clearly marked with time drawn and the exact location of the sample collection. Submit all tubes with one test requisition.
Transport Temperature
Frozen
Specimen Stability
Room temperature: 4 days
Refrigerated: 7 days
Frozen: 28 days
Refrigerated: 7 days
Frozen: 28 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Moderate to gross hemolysis • Serum separator tubes (SST)
Methodology
Liquid Chromatography Tandem Mass Spectrometry (LC/MS/MS)
FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
Setup Schedule
P.M.
Clinical Significance
Measurements of aldosterone/cortisol ratios in samples of adrenal venous blood, obtained by an experienced radiologist, is the "gold standard" test to distinguish between an adenoma or unilateral hyperplasia and bilateral hyperplasia. Unilateral disease is associated with a marked (usually greater than four-fold) increase in Aldosterone/Cortisol on the side of the tumor, whereas there is little difference between the two sides in patients with bilateral hyperplasia. AVS with Aldosterone/Cortisol measurement is indicated if imaging studies fail to unequivocally identify an adenoma or if the identified adenoma is <1 cm in size.
