CXCR4 PET/CT成像对肾上腺切除术后单侧原发性醛固酮增多症患者的预后价值。

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

EJNMMI Research Pub Date : 2025-04-17 DOI:10.1186/s13550-025-01242-6

Shuai Shao, Haozhe Xu, Zhuo Xing, Yulong Hong, Xuan Yin, Jianguang Luo, Kai Ai, Xin Su, Xiaowei Ma, Yuan Li

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引用次数: 0

摘要

背景：CXCR4 PET/CT成像已成为原发性醛固酮增多症（PA）的诊断和分型工具。但其对术后血压恢复的预后价值尚未得到充分讨论。结果：在3个月和6个月的评估中，病变SUVmax与对侧肾上腺组织SUVmean ratio （LCR）被确定为临床成功的独立预测因子。LCR的AUC在3个月时为0.894,6个月时为0.832。根据最佳临界值3.240将患者分为高、低LCR组。与低LCR组相比，高LCR组表现为CXCR4和CYP11B2表达升高，PAC水平升高，获得临床完全成功的可能性更大。LCR与侧化指数和对侧抑制指数相关。结论：LCR是PA术后血压恢复的可靠独立预测指标。LCR大于3.240的患者可能从肾上腺切除术中获益更多。我们建议在PA患者中增加CXCR4 PET/CT的使用。注册:ChiCTR2200062844。注册于2022年8月20日。

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The prognostic value of CXCR4 PET/CT imaging in unilateral primary aldosteronism patients after adrenalectomy.

Background: CXCR4 PET/CT imaging has emerged as a tool for diagnosis and subtyping of primary aldosteronism (PA). But its prognostic value for postoperative blood pressure recovery has not been fully discussed.

Results: The lesional SUVmax to the contralateral adrenal tissue SUVmean ratio (LCR) was identified as an independent predictor of clinical success at both the 3-month and 6-month assessments. The AUC for LCR was 0.894 at the 3-month and 0.832 at the 6-month. Patients were divided into high and low LCR groups according to the optimal cut-off of 3.240. The high LCR group exhibited elevated CXCR4 and CYP11B2 expression, higher PAC level, a greater probability of achieving complete clinical success compared to the low LCR group. Moreover, LCR was correlated with lateralization index and contralateral suppression index.

Conclusions: LCR is a reliable independent predictor of postoperative blood pressure recovery in PA. Patients with LCR over 3.240 may benefit more from adrenalectomy. We recommend increased utilization of CXCR4 PET/CT for patients with PA.

Registration: ChiCTR2200062844. Registered 20 August 2022.

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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.