Poster Presentation 5th International Symposium on Phaeochromocytoma and Paraganglioma 2017

Survey of RCPAQAP participants regarding their measurement and reporting of plasma metanephrines (#77)

Wilson Punyalack 1 , Gerald Woollard 1 , Malcolm Whiting 1 , Talia Novos 1 , Sabrina Koestier 1 , Brett McWhinney 1 , Kirsten Hoad 1 , Andrew Ellis 1 , Trisha Andersen 1
  1. Members RCPAQAP Advisory Committee on Biogenic Amines (ACBA), St Leonards, NSW 2065, Australia

Introduction

Plasma free metanephrines (PMET) are a recommended test for the biochemical diagnosis of phaeochromocytoma and paraganglioma. In 2008, The Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) introduced the first external quality assurance program for laboratories that measure these analytes. This program has grown internationally with 56 current enrolments. Although nearly all laboratories now utilise mass spectrometry, there are many analytical variables to consider when performing this diagnostic test. ACBA decided to survey laboratories world-wide to determine the degree of harmony that exists for analytical factors associated with PMET performance, and for compliance with clinical practice guidelines1.              

Methods

In late 2016, information on analytical variables was requested from all RCPAQAP PMET laboratories (51) in the form of a questionnaire. Details included how plasma samples were collected and stored, analytes measured, the type of chromatography and mass spectrometer in use, sources of calibrators and quality controls, and reference ranges used to interpret results. Survey data were collated and categorised to provide summary tables for analysis.

Results

28 participants (55%) from 13 countries across Oceania, Asia, Europe and North America responded to the questionnaire. Questions relating to mass spectrometry parameters displayed the greatest harmony between laboratories, with all respondents indicating identical ionisation source type (Electrospray), ionisation mode (positive) and the use of isotopically labelled internal standards. Pre-analytical and patient preparation practices between laboratories showed the greatest disharmony. The majority of labs (86%) were aware of the Endocrine Society Guidelines.

Summary

Although clinical practice guidelines were established in 2014, this survey highlights that practices relating to the measurement of PMET by mass spectrometry show greater harmony during the analytical phase compared to that of the pre-analytical phase amongst 2016 RCPAQAP participants.

 

 

  1. Lenders et al. (2014) Pheochromocytoma and Paraganglioma: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 99:1915-42