Typing diagnostic value of 68Ga-pentixafor PET/CT for patients with primary aldosteronism and unilateral nodules

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2024-09-09 DOI:10.1007/s12020-024-04024-7

Rui Zuo, Shuang Liu, Xinyi Ren, Wenbo Li, Zhu Xia, Lu Xu, Hua Pang

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Abstract

Purpose

Our goal was to compare the lateralization of ⁶⁸Ga-pentixafor PET/CT with adrenal vein sampling (AVS) in primary aldosteronism (PA) patients with unilateral lesions.

Methods

We retrospectively enrolled 61 patients with PA and all patients showed unilateral nodular lesions on CT and underwent ⁶⁸Ga-Pentixafor PET/CT. The general clinical data, imaging and AVS results were collected. The diagnostic efficiency of ⁶⁸Ga-Pentixafor PET/CT imaging in PA patients was calculated by visual and semi-quantitative analysis to compare the consistency with AVS, and the correlation between CXCR4 express and ⁶⁸Ga-Pentixafor uptake was performed.

Results

The study included 42 unilateral PA (UPA) and 19 bilateral PA (BPA). The area under curve (AUC) of ⁶⁸Ga-Pentixafor PET/CT to diagnosis UPA with 10 min maximum standardized uptake value (SUVmax) > 8.17 was 0.82 ([0.70–0.90], P < 0.001), and the sensitivity and specificity were 0.64 and 0.90, respectively. The maximal AUC of ⁶⁸Ga-pentixafor PET/CT for the diagnosis UPA in patients with nodules with a diameter ≥1 cm was 0.87 ([0.73–0.95],P both <0.001,[10 min SUVmax=8.17 and 10 min mean standardized uptake value (SUVmean)=5.57]), and the sensitivity and specificity were 0.73 and 0.93, respectively. Unilateral adrenalectomy and significant CXCR4 expression were present in 32 UPA, including 27 aldosterone-producing adenoma and 5 idiopathic adrenal hyperplasia. Additionally, ⁶⁸Ga-pentixafor uptake in adrenal lesions was significantly correlated with CXCR4 expression, and statistical differences in ⁶⁸Ga-pentixafor uptake among IRS subgroups.

Conclusions

⁶⁸Ga-Pentixafor PET/CT can be helpful for subtyping diagnosis of PA patients with unilateral adrenal nodular, showing significant potential in non-invasive PA classification.

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68Ga-pentixafor PET/CT 对原发性醛固酮增多症和单侧结节患者的类型诊断价值

目的我们的目标是比较 68Ga-pentixafor PET/CT 与肾上腺静脉取样（AVS）对单侧病变的原发性醛固酮增多症（PA）患者的侧位作用。方法我们回顾性地纳入了 61 例 PA 患者，所有患者均在 CT 上显示单侧结节性病变，并接受了 68Ga-Pentixafor PET/CT。收集了一般临床资料、影像学和 AVS 结果。通过目测和半定量分析计算 68Ga-Pentixafor PET/CT 对 PA 患者的诊断效率，比较与 AVS 的一致性，并进行 CXCR4 表达与 68Ga-Pentixafor 摄取的相关性分析。68Ga-Pentixafor PET/CT 诊断 10 min 最大标准化摄取值（SUVmax）为 8.17 的 UPA 的曲线下面积（AUC）为 0.82（[0.70-0.90]，P< 0.001），敏感性和特异性分别为 0.64 和 0.90。68Ga-pentixafor PET/CT 对直径≥1 cm结节患者诊断 UPA 的最大 AUC 为 0.87（[0.73-0.95],P 均为 0.001，[10 min SUVmax=8.17 和 10 min 平均标准化摄取值（SUVmean）=5.57]），敏感性和特异性分别为 0.73 和 0.93。在 32 例 UPA（包括 27 例醛固酮生成腺瘤和 5 例特发性肾上腺增生症）中进行了单侧肾上腺切除术，并发现有明显的 CXCR4 表达。结论68Ga-Pentixafor PET/CT有助于单侧肾上腺结节性PA患者的亚型诊断，在无创PA分类中显示出巨大潜力。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.