Clinical value of Ga-pentixafor PET/CT in patients with primary aldosteronism and bilateral lesions: preliminary results of a single-centre study.

BACKGROUND

Subtype diagnosis of primary aldosteronism (PA) is used to determine treatment, and the potential utility of Ga-pentixafor PET/CT for investigation of PA has long been recognized. The study aimed to evaluate the clinical value of Ga-pentixafor PET/CT in the diagnosis and prognosis of patients with bilateral lesions identified by CT.

METHODS

In total, 25 patients with PA and bilateral lesions on CT were retrospectively evaluated. All patients underwent Ga-Pentixafor PET/CT and adrenal vein sampling. The analysis focused on establishing the relationship between bilateral adrenal lesions SUVmax and the ratio of bilateral adrenal lesions SUVmax (CON) and clinical diagnosis, treatment outcomes, and KCNJ5 gene status.

RESULTS

The concordance rate between Ga-Pentixafor PET/CT and adrenal venous sampling was 65.2% (15/23). The lateralization results of Ga-pentixafor PET/CT supported the clinical decisions of 20 patients with PA, 90% of whom showed effectiveness in treatment. The SUVmax on the dominant side of the surgically treated patients was higher than that of patients treated with drugs. The SUVmax of the KCNJ5 mutant group was higher than that of the KCNJ5 wild group, and Ga-Pentixafor uptake was correlated with KCNJ5 gene status.

CONCLUSIONS

Ga-Pentixafor PET/CT proves beneficial for patients with PA with bilateral lesions on CT. The treatment is generally effective based on the results of PET lateralization. Simultaneously, a certain relationship exists between Ga-Pentixafor PET/CT and KCNJ5 gene status, warranting further analysis.