Women's & Men's Health

Session: Educational Exhibit Presentations - Station 12: Women's & Men's Health

Guilty as Charged: Utilizing Selective Ovarian and Adrenal Vein Sampling to Localize Neoplastic Hyperandrogenism

Monday, March 6, 2023

5:10 PM – 5:15 PM

Location: Phoenix Convention Center, North Ballroom 120ABC, Poster Hall

Abstract Presenter(s)

SB

Stefan Brancel, MD (he/him/his)

Diagnostic Radiology Resident
Henry Ford Hospital

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

CS

Claire Sorek, MD

Diagnostic Radiology Resident
Henry Ford Hospital
KK

Katherine Keith, MS

Medical Student
Wayne State University: School of Medicine
DM

David McVinnie, MD

Interventional Radiologist
Henry Ford Hospital

Disclosure(s):

Stefan Brancel, MD: No financial relationships to disclose

Learning Objectives:

Appropriately identify clinical scenarios in which to perform selective adrenal and ovarian vein sampling (SOAVS).

Describe relevant normal anatomy, variant anatomy, and fluoroscopic landmarks.

Discuss technical aspects of the procedure including catheter type, confirmation of catheter positioning, and appropriate laboratory tests.

Understand test results to localize the cause of hyperandrogenism.

Background: SOAVS is an uncommon procedure used for localization of androgen secreting tumors when advanced imaging is unable to identify a source and dexamethasone test does not suppress androgen {1}. It is a notoriously difficult procedure with successful canulation of all 4 veins occurring less than 50% of the time in literature reports {2, 3, 4}. Given the rarity of the procedures in modern day interventional radiology practice we aim to present a comprehensive overview of SOAVS in an interactive manner.

Clinical Findings/Procedure Details: After providing a general overview of patient selection, important anatomic considerations, catheter selection and positioning, and result interpretation we shift to an interactive learning format. Utilizing a QR code participants are able to practice their procedural decision making through sample images drawn from 5 cases performed at our institution. Interspersed between procedural decision making are questions reviewing the presented information.

Conclusion and/or Teaching Points: SOAVS can play an important role in localization of imaging occult neoplastic hyperandrogenism. In these rare circumstances knowledge of how to perform this technically challenging procedure can help successfully guide surgical treatment.