Do you recommend checking plasma metanephrine levels during adrenal venous sampling to assist in assessing lateralization in primary aldosteronism?

I have not concluded yet that the measurement helps with lateralization. At this point, the best use of measuring plasma metanephrines or androstenedione in patients with hypercortisolism and bilateral adrenal pathology is to confirm accurate adrenal vein catheterization. In my opinion, the literature is not conclusive on whether the absolute cortisol ratios or corrected values for metanephrines or androstenedione are the best way to predict lateralization. We need more data and well-designed studies on this question.