Hyeon Yu (editor) - Diagnosis and Management of Endocrine Disorders in Interventional Radiology

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Diseases of the endocrine system involve an imbalance in the natural homeostasis of the hormones produced by the glands in the body. There are a variety of endocrine conditions characterized by either hormonal hyposecretion or hypersecretion. Often, these conditions can lead to debilitating or, in some instances, life-threatening situations that can be challenging to diagnose and treat. While one doesnt often consider interventional radiology a critical part of the endocrine clinic setting, there are several conditions for which interventional radiologists can play a valuable role. These disorders include primary aldosteronism, primary hyperparathyroidism, Cushings disease, hormone-secreting pancreatic adenomas, and androgen-secreting ovarian tumors. A collaboration of multiple specialties, including endocrinologists, surgeons, and radiologists, is often needed to diagnose and manage these conditions.

Radiologists play a prominent role in the evaluation of patients with suspected endocrine disorders. CT and MRI are commonly used first-line imaging modalities; however, cross-sectional imaging lacks physiologic information resulting in poor specificity of these tests for many endocrine conditions. Thus, percutaneous selective venous sampling is a useful diagnostic tool for the medical and surgical management of patients with select endocrine disorders. Selective venous sampling is a minimally invasive interventional procedure performed by interventional radiologists to localize sites of abnormal hormone secretion. These tests can confirm a suspected clinical diagnosis and, in some instances, direct curative surgical therapy.

As venous sampling procedures are increasingly performed worldwide, the collaboration between interventional radiology, endocrinology, surgical endocrinology, surgical oncology, neurosurgery, and gynecology teams is essential. Currently, there are limited guidelines from The Endocrine Society and relatively few published papers for each venous sampling procedure. Furthermore, except for the book Percutaneous Venous Blood Sampling in Endocrine Diseases published in 1992 by Springer, there is no modern comprehensive guide for all traditional and newly emerging selective venous sampling procedures.

To correct this information gap, we have put together a book focusing on selective venous sampling, including the interventional techniques for diagnosis and chapters on the pathophysiology, epidemiology, clinical diagnosis, and medical, surgical, and interventional treatments of endocrine disorders. We have recruited experts from endocrinology, endocrine surgery, radiology, and interventional radiology to provide a comprehensive and state-of-the-art textbook surrounding the diseases in which venous sampling is typically used. We have also included chapters on the latest percutaneous therapies that may be the future for treating some common endocrine disorders, such as hyperthyroidism and hyperparathyroidism. And given the rise in pediatric interventional radiology in recent years, we felt it was important to dedicate a chapter to venous sampling in this patient population.

This book is organized into five parts: Clinical, Laboratory, and Radiological Diagnosis, Selective Venous Sampling, Medical and Surgical Management, and Intervention Treatments, with chapters in each part addressing primary aldosteronism, hyperparathyroidism, hyperandrogenism, hypercortisolism, and pancreatic islet cell tumors. This type of organization allows the reader to read the book straight through to get a comprehensive overview from the initial evaluation through the different management options for these disease processes. Alternatively, the reader can select specific chapters to answer a particular question or focus on a single disease process.

As interventional radiologists, we have experienced firsthand the value and complexity that venous sampling procedures can provide. These procedures can be gratifying and significantly improve patient care. Understanding the relevant disease processes from the perspective of the other members of the multi-disciplinary teams and learning the selective venous sampling techniques from the experts will help guide the interventional radiologist to be a more valuable team member. We have thoroughly enjoyed the process of bringing this book together, and we hope that all readers who are involved in the management of these patients will find this book a valuable reference for many years.