68ga - pentxapet /CT指导原发性醛固酮增多症的手术治疗

IF 4.2 Q1 ENDOCRINOLOGY & METABOLISM

Journal of Clinical and Translational Endocrinology Pub Date : 2025-01-25 DOI:10.1016/j.jcte.2025.100384

Guoyang Zheng , Jie Ding , Yinjie Gao , Shengyan Liu , Xinchun Yan , Wenda Wang , Yang Zhao , Zhan Wang , Li Huo , Anli Tong , Yushi Zhang

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The relationship between radionuclide imaging characteristics and postoperative outcomes was assessed following surgery.</div></div><div><h3>Results</h3><div>The positive detection rate of <sup>68</sup>Ga-pentixafor PET/CT in 91 PA patients was 85.7 % (78/91) with a median maximum standardized uptake value (SUV<sub>max</sub>) of 10.2 (6.0–16.0). The SUV<sub>max</sub> was positively correlated with lesion diameter (<em>r</em> = 0.497, <em>P</em> < 0.001), while negatively correlated with the blood potassium level (<em>r</em> = -0.450, <em>P</em> < 0.001) and plasma renin activity (<em>r</em> = -0.297, <em>P</em> = 0.004). 63 cases of 73 PA patients with unilateral adrenal lesion were identified positive by <sup>68</sup>Ga-pentixafor PET/CT, and 95.2 % of the 63 positive cases benefited from surgical resection of the identified positive lesions. 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引用次数: 0

摘要

目的本研究旨在通过识别功能性病变，确定醛固酮分泌优势侧，探讨68ga - pentxafor PET/CT在指导原发性醛固酮增多症（PA）患者手术治疗中的意义。材料与方法根据68ga - pentxafor PET/CT结果，前瞻性纳入91例接受手术治疗的PA患者。68ga - pentxafor PET/CT图像通过视觉和半定量分析评估。术后评估放射性核素成像特征与术后预后的关系。结果91例PA患者PET/CT检出68ga - pentixa78 /91，阳性检出率85.7%，最大标准化摄取值（SUVmax）中位数为10.2（6.0 ~ 16.0）。SUVmax与病变直径呈正相关(r = 0.497, P <；0.001)，而与血钾水平呈负相关(r = -0.450, P <；0.001)和血浆肾素活性（r = -0.297, P = 0.004）。73例PA单侧肾上腺病变患者中63例经68ga - pentxafor PET/CT检测为阳性，其中95.2%的阳性病例经手术切除。在18例双侧病变的PA患者中，68Ga-pentixafor PET/CT检出阳性病灶15例，其中86.7%（13/15）的阳性病例在68Ga-pentixafor PET/CT指导下行肾上腺全切除或部分切除。部分肾上腺切除术与全肾上腺切除术患者的术后预后无显著差异。68ga - pentxapet /CT测定PA醛固酮分泌优势侧的准确率为85.7%，与肾上腺静脉取样（AVS）的71.4%相当。结论68ga - pentxafor PET/CT可有效指导PA患者的手术处理，获得良好的术后效果。68ga - pentxapet /CT鉴别醛固酮分泌优势侧的准确率不低于AVS。

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68Ga-pentixafor PET/CT in guiding surgical management of primary aldosteronism

Purpose

This study aimed to explore the significance of ⁶⁸Ga-pentixafor PET/CT in guiding surgical treatments for primary aldosteronism (PA) patients, by identifying functional lesions and determining the dominant side of aldosterone secretion.

Materials and methods

We prospectively included 91 PA patients receiving surgical treatments based on the results of ⁶⁸Ga-pentixafor PET/CT. The ⁶⁸Ga-pentixafor PET/CT images were evaluated by visual and semi-quantitative analysis. The relationship between radionuclide imaging characteristics and postoperative outcomes was assessed following surgery.

Results

The positive detection rate of ⁶⁸Ga-pentixafor PET/CT in 91 PA patients was 85.7 % (78/91) with a median maximum standardized uptake value (SUV_max) of 10.2 (6.0–16.0). The SUV_max was positively correlated with lesion diameter (r = 0.497, P < 0.001), while negatively correlated with the blood potassium level (r = -0.450, P < 0.001) and plasma renin activity (r = -0.297, P = 0.004). 63 cases of 73 PA patients with unilateral adrenal lesion were identified positive by ⁶⁸Ga-pentixafor PET/CT, and 95.2 % of the 63 positive cases benefited from surgical resection of the identified positive lesions. Among 18 PA patients with bilateral lesions, ⁶⁸Ga-pentixafor PET/CT identified positive lesions in 15 cases, and 86.7 % (13/15) of the positive cases benefited from total or partial adrenalectomy guided by ⁶⁸Ga-pentixafor PET/CT. There was no significant difference in postoperative outcomes between patients undergoing partial adrenalectomy with those subjected to total adrenalectomy. The accuracy rate of ⁶⁸Ga-pentixafor PET/CT in determining the dominant side of aldosterone secretion for PA was 85.7 %, which was comparable to the 71.4 % of adrenal vein sampling (AVS).

Conclusions

⁶⁸Ga-pentixafor PET/CT could effectively guide the surgical management for PA patients, achieving favorable postoperative outcomes. The accuracy rate of ⁶⁸Ga-pentixafor PET/CT in identifying the dominant side of aldosterone secretion was not inferior to that of AVS.

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来源期刊

Journal of Clinical and Translational Endocrinology ENDOCRINOLOGY & METABOLISM-

CiteScore

6.10

自引率

0.00%

发文量

审稿时长

16 weeks