Sato Tomohiro, Matsutomo Norikazu, Yamamoto Tomoaki, Fukami Mitsuha, Kono Takashi
Department of Radiology, Chiba Aoba Municipal Hospital, 1273-2 Aoba-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-0852, Japan.
Department of Medical Radiological Technology, Faculty of Health Sciences, Graduate School of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-Shi, Tokyo, 181-8612, Japan.
Ann Nucl Med. 2023 Feb;37(2):89-98. doi: 10.1007/s12149-022-01805-w. Epub 2022 Nov 15.
Adrenal venous sampling (AVS) is a reliable method for lateralization of adrenal hormone secretion, which is important for discriminating between aldosterone-producing adenoma and bilateral adrenal hyperplasia, both of which cause primary aldosteronism (PA). The aim of this study was to evaluate the diagnostic accuracy of the maximum and mean standardized uptake values (SUV and SUV, respectively) of I-6β-iodomethyl-19-norcholesterol (NP-59) single-photon emission computed tomography (SPECT) for PA and its correspondence with AVS.
Adrenal NP-59 scintigraphy was performed in 14 patients with suspected PA, and AVS was also performed in 7 of them. SUV and SUV of the adrenal lesions on the dominant side and their ratios to the values on the non-dominant side (SUVR and SUVR, respectively) were calculated on SPECT images using ordered-subset conjugate gradient minimization (OSCGM) and three-dimensional ordered-subset expectation maximization (3D-OSEM) reconstruction algorithms.
SUV and SUV on NP-59 SPECT images were significantly higher for aldosterone-producing adenoma than for bilateral adrenal hyperplasia or non-functioning adenoma and slightly superior to SUVR and SUVR (P = 0.0475 and P = 0.0447 vs. P = 0.124 and P = 0.132, respectively, with OSCGM). The respective areas under the receiver-operating characteristic curve for SUV and SUVR were 0.933 and 0.725 with OSCGM and 0.844 and 0.750 with 3D-OSEM, while SUV and SUVR had exactly the same diagnostic accuracy as SUV and SUVR. SUV and SUVR were associated with the diagnostic features on AVS and consistent with lateralization by AVS in most patients.
In this study, SUV on NP-59 SPECT helped in the diagnosis of PA and was consistent with the results of AVS in nearly all cases.
肾上腺静脉采血（AVS）是一种用于肾上腺激素分泌侧别定位的可靠方法，这对于鉴别醛固酮瘤和双侧肾上腺增生至关重要，这两种情况均可导致原发性醛固酮增多症（PA）。本研究的目的是评估I-6β-碘甲基-19-去甲胆固醇（NP-59）单光子发射计算机断层扫描（SPECT）的最大和平均标准化摄取值（分别为SUV和SUV）对PA的诊断准确性及其与AVS的一致性。
对14例疑似PA的患者进行肾上腺NP-59闪烁扫描，其中7例患者也进行了AVS。使用有序子集共轭梯度最小化（OSCGM）和三维有序子集期望最大化（3D-OSEM）重建算法在SPECT图像上计算优势侧肾上腺病变的SUV和SUV及其与非优势侧值的比值（分别为SUVR和SUV）。
NP-59 SPECT图像上，醛固酮瘤的SUV和SUV显著高于双侧肾上腺增生或无功能腺瘤，且略优于SUVR和SUV（使用OSCGM时，P分别为0.0475和0.0447，而SUVR和SUV的P分别为0.124和0.132）。使用OSCGM时，SUV和SUVR的受试者操作特征曲线下面积分别为0.933和0.725，使用3D-OSEM时分别为0.844和0.750，而SUV和SUV的诊断准确性与SUV和SUV完全相同。SUV和SUVR与AVS的诊断特征相关，并且在大多数患者中与AVS的侧别定位一致。
在本研究中，NP-59 SPECT上的SUV有助于PA的诊断，并且在几乎所有病例中与AVS的结果一致。
