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
{"title":"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？","authors":"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","doi":"10.1186/s13550-025-01309-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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 <sup>68</sup>Ga-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.</p><p><strong>Results: </strong>Among the 51 patients who underwent <sup>68</sup>Ga-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 <sup>68</sup>Ga-pentixafor PET/CT-guided surgical patients revealed that 86.11% had adrenocortical adenomas with positive CYP11B2 and CXCR4 expression.</p><p><strong>Conclusion: </strong>CXCR4-targeted <sup>68</sup>Ga-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.</p><p><strong>Trial registration: </strong><sup>68</sup>Ga-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 .</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":"15 1","pages":"111"},"PeriodicalIF":3.1000,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394099/pdf/","citationCount":"0","resultStr":"{\"title\":\"Is CXCR4-targeted <sup>68</sup>Ga-pentixafor PET/CT a reliable AVS-free modality for surgical decision-making and prognostic prediction in primary aldosteronism with bilateral adrenal lesions?\",\"authors\":\"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\",\"doi\":\"10.1186/s13550-025-01309-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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 <sup>68</sup>Ga-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.</p><p><strong>Results: </strong>Among the 51 patients who underwent <sup>68</sup>Ga-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 <sup>68</sup>Ga-pentixafor PET/CT-guided surgical patients revealed that 86.11% had adrenocortical adenomas with positive CYP11B2 and CXCR4 expression.</p><p><strong>Conclusion: </strong>CXCR4-targeted <sup>68</sup>Ga-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.</p><p><strong>Trial registration: </strong><sup>68</sup>Ga-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 .</p>\",\"PeriodicalId\":11611,\"journal\":{\"name\":\"EJNMMI Research\",\"volume\":\"15 1\",\"pages\":\"111\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-08-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394099/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"EJNMMI Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13550-025-01309-4\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"EJNMMI Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13550-025-01309-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
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?
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 .
EJNMMI ResearchRADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING&nb-
CiteScore
5.90
自引率
3.10%
发文量
72
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.
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