Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Endocrinology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China.
Endocrine. 2024 Sep;85(3):1398-1406. doi: 10.1007/s12020-024-03865-6. Epub 2024 Jun 24.
Adrenal venous sampling (AVS) is recommended for subtyping primary aldosteronism (PA). However, in cases of PA, concurrent subclinical Cushing's syndrome (SCS) has the potential to confound AVS results. Pentixafor, a CXC chemokine receptor type 4-specific ligand, has been reported as a promising marker to evaluate functional nature of adrenal adenomas. This study aims to investigate the clinical value of Gallium-68 Pentixafor Positron Emission Tomography-Computed Tomography (Ga-Pentixafor PET/CT) in the localization diagnosis of patients with PA plus SCS.
Two patients with a confirmed diagnosis of PA plus SCS underwent AVS and Ga-Pentixafor PET/CT.
AVS results revealed no lateralization for both patients while Ga-Pentixafor PET/CT showed a unilateral adrenal nodule with increased uptake of Ga-Pentixafor. Unilateral adrenalectomy was performed based on the results of Ga-Pentixafor PET/CT. Subsequently, complete biochemical remission of autonomous aldosterone and cortisol secretion were achieved in both cases.
Ga-Pentixafor PET/CT shows promising potential for the localization of aldosterone and cortisol co-secreting adrenal adenoma in patients with PA plus SCS.
肾上腺静脉采样（AVS）被推荐用于原发性醛固酮增多症（PA）的分型。然而，在 PA 病例中，亚临床库欣综合征（SCS）有可能混淆 AVS 结果。Pentixafor 是一种趋化因子受体 4 特异性配体，已被报道为评估肾上腺腺瘤功能性质的有前途的标志物。本研究旨在探讨镓-68 Pentixafor 正电子发射断层扫描-计算机断层扫描（Ga-Pentixafor PET/CT）在伴有 SCS 的 PA 患者定位诊断中的临床价值。
两名确诊为 PA 伴 SCS 的患者接受了 AVS 和 Ga-Pentixafor PET/CT 检查。
AVS 结果显示两名患者均无侧化，而 Ga-Pentixafor PET/CT 显示单侧肾上腺结节摄取 Ga-Pentixafor 增加。根据 Ga-Pentixafor PET/CT 的结果，对单侧肾上腺进行了切除术。随后，两名患者的自主醛固酮和皮质醇分泌均完全生化缓解。
Ga-Pentixafor PET/CT 显示出在伴有 SCS 的 PA 患者中定位醛固酮和皮质醇共分泌肾上腺腺瘤的有前途的潜力。
