Is CXCR4-targeted ⁶⁸Ga-pentixafor PET/CT a reliable AVS-free modality for surgical decision-making and prognostic prediction in primary aldosteronism with bilateral adrenal lesions?

IF 3.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

EJNMMI Research Pub Date : 2025-08-28 DOI:10.1186/s13550-025-01309-4

Zhiwei Shu, Yao He, Tingting Long, Min Guo, Zhuying Xia, Xiaodan Fu, Bingsheng Li, Bo Zhang, Yi Yang, Jiaxian Chen, Tiejian Jiang, Xiang Chen, Kai Cheng, Longfei Liu, Yu Gan

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引用次数: 0

Abstract

Background: For patients diagnosed with primary aldosteronism (PA) accompanied by bilateral adrenal lesions, identifying optimal candidates for surgical intervention remains a significant clinical challenge. Although adrenal venous sampling (AVS) is currently the gold standard for lateralizing aldosterone hypersecretion, its technical complexity, invasiveness, and interpretive difficulties restrict its widespread adoption. In this study, we aimed to investigate the clinical application of ⁶⁸Ga-pentixafor positron emission tomography/computed tomography (PET/CT) as a non-invasive imaging modality in AVS-free surgical decision-making for PA patients with bilateral adrenal lesions.

Results: Among the 51 patients who underwent ⁶⁸Ga-pentixafor PET/CT, 36 patients had adrenalectomy, with the surgical side determined by PET/CT lateralization. The postoperative complete biochemical and clinical success rates for these patients were 91.67% and 100%, respectively. Additionally, receiver operating characteristic curve analysis indicated that PET/CT results were favorable predictors of postoperative outcomes in surgical patients. Postoperative pathological evaluation of ⁶⁸Ga-pentixafor PET/CT-guided surgical patients revealed that 86.11% had adrenocortical adenomas with positive CYP11B2 and CXCR4 expression.

Conclusion: CXCR4-targeted ⁶⁸Ga-pentixafor PET/CT can be effectively utilized in surgery decision-making for PA patients with bilateral adrenal lesions, offering a potential alternative to AVS and maybe applied to predict postoperative biochemical and clinical success.

Trial registration: ⁶⁸Ga-Pentixafor PET/CT for Guiding Surgical Treatment of Primary Aldosteronism With Bilateral Adrenal Lesions; Trial registration number: NCT06247566; Date of registration: 2021-11-01; URL of trial registry record: https://clinicaltrials.gov/study/NCT06247566 .

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在原发性醛固酮增多症合并双侧肾上腺病变的手术决策和预后预测中，靶向cxcr4的68ga - pentxapet /CT是否是一种可靠的无avs模式？

背景：对于诊断为原发性醛固酮增多症（PA）并伴有双侧肾上腺病变的患者，确定手术干预的最佳候选人仍然是一个重大的临床挑战。虽然肾上腺静脉取样（AVS）目前是侧化醛固酮高分泌的金标准，但其技术复杂性、侵入性和解释困难限制了其广泛采用。在本研究中，我们旨在探讨68ga - pentxafor正电子发射断层扫描/计算机断层扫描（PET/CT）作为无创成像方式在PA患者双侧肾上腺病变无avs手术决策中的临床应用。结果：51例行68ga - pentxafor PET/CT的患者中，36例行肾上腺切除术，手术侧位通过PET/CT确定。术后生化完全成功率为91.67%，临床成功率为100%。此外，接受者工作特征曲线分析表明，PET/CT结果是手术患者术后预后的良好预测指标。68ga - pentxa用于PET/ ct引导下手术患者的术后病理评估显示，86.11%的患者有肾上腺皮质腺瘤，CYP11B2和CXCR4阳性表达。结论：cxcr4靶向68ga - pentxafor PET/CT可有效用于PA双侧肾上腺病变患者的手术决策，为AVS提供了潜在的替代方案，可用于预测术后生化和临床成功。试验注册：68ga - pentxafor PET/CT指导双侧肾上腺病变原发性醛固酮增多症的手术治疗试验注册号：NCT06247566；报名日期：20121-11-01；试用注册表记录的URL: https://clinicaltrials.gov/study/NCT06247566。

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来源期刊

EJNMMI Research RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING&nb-

CiteScore

5.90

自引率

3.10%

发文量

审稿时长

13 weeks

期刊介绍： EJNMMI Research publishes new basic, translational and clinical research in the field of nuclear medicine and molecular imaging. Regular features include original research articles, rapid communication of preliminary data on innovative research, interesting case reports, editorials, and letters to the editor. Educational articles on basic sciences, fundamental aspects and controversy related to pre-clinical and clinical research or ethical aspects of research are also welcome. Timely reviews provide updates on current applications, issues in imaging research and translational aspects of nuclear medicine and molecular imaging technologies. The main emphasis is placed on the development of targeted imaging with radiopharmaceuticals within the broader context of molecular probes to enhance understanding and characterisation of the complex biological processes underlying disease and to develop, test and guide new treatment modalities, including radionuclide therapy.