Primary aldosteronism classification with 18-oxocortisol and ⁶⁸Ga-pentixafor PET/CT.

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2025-02-25 DOI:10.1016/j.eprac.2025.02.012

Yinjie Gao, Jie Ding, Yu Wang, Yue Zhou, Yushi Zhang, Ling Qiu, Li Huo, Anli Tong

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引用次数: 0

Abstract

Objective: This study aimed to explore the non-invasive and accurate evaluation methods of primary aldosteronism (PA) classification.

Methods: There were 99 patients with aldosterone-producing adenoma (APA) and 61 with idiopathic hyperaldosteronism (IHA) recruited in this study. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) and ⁶⁸Ga-pentixafor PET/CT were performed in this cohort. Statistical analysis was used to calculate the diagnostic efficiency of single or double methods.

Results: In steroid profiling detected by LC-MS/MS, the average levels of six steroids apart from aldosterone in APA group were higher than those in IHA group. The differential diagnostic efficiency of 18-oxocortisol (cutoff value at 0.132 ng/mL) was greater than other steroids, with the sensitivity of 75.3%, and the specificity of 91.2%. As for ⁶⁸Ga-pentixafor PET/CT, visual analysis showed the sensitivity of 93.7%, and the specificity of 56.3%. And at the optimum SUV_max of 8.00, the sensitivity was 69.8%, and the specificity was 93.7%. Taking into account the 18-oxocortisol level and ⁶⁸Ga-pentixafor PET/CT SUV_max, 100% patients with double positive results were placed in the right APA subtype. If 18-oxocortisol level with ⁶⁸Ga-pentixafor PET/CT visual analysis were combined for PA subtyping, the sensitivity of at least one positive was 95.2%, and a total of 87.2% of patients could be classified correctly.

Conclusion: The LC-MS/MS and ⁶⁸Ga-pentixafor PET/CT have great advantages on the subtyping of PA. There was a high accuracy of the combination of the two methods, which will contribute to avoid an unnecessary AVS operation before surgery for most PA patients.

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.