Gege Zhao, Ling Zhao, Bin Ji
Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun 130033, China.
Department of Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, China.
Eur J Radiol. 2025 Sep;190:112240. doi: 10.1016/j.ejrad.2025.112240. Epub 2025 Jun 14.
To evaluate the diagnostic performance of Pentixafor PET/CT for identification of unilateral primary aldosteronism (PA).
The PubMed and Embase databases were searched to identify relevant articles published through March 2025. Studies using various combinations of adrenal venous sampling (AVS), clinical information, pathologic and post-surgical follow-up data as reference standard to report the diagnostic accuracy of Pentixafor PET/CT in identifying unilateral PA were included. The pooled sensitivity, specificity, and area under the summary receiver-operating characteristics curve (AUC) were determined by using bivariate random-effects model. We also included studies in which patients who had undergone both Pentixafor PET/CT and a successful AVS can be identified. The PET/CT result was considered in agreement with AVS when AVS showed unilaterally increased aldosterone secretion on the same side as the abnormality seen on PET/CT or when AVS showed symmetric aldosterone secretion and PET/CT revealed bilateral or no unilateral abnormality.
Seven studies with 603 patients were eligible for assessing diagnostic accuracy. The pooled sensitivity, specificity, and AUC value for Pentixafor PET/CT in indentifying unilateral PA were 80 % (95 % CI, 70-87 %), 91 % (95 % CI, 86-94 %), and 0.91 (95 % CI, 0.89-0.94), respectively. Five studies with 189 patients were eligible for assessing agreement between the results from Pentixafor PET/CT and AVS. The proportion of patients whose PET/CT results agreed with those of AVS was 79.3 % (150/189).
This meta-analysis showed that Pentixafor PET/CT has high diagnostic accuracy for the identification of unilateral PA. In addition, Pentixafor PET/CT results are also in good agreement with those of AVS as to indicating left or right side of aldosterone hypersecretion, or no lateralization. These results confirmed the promising role of Pentixafor PET/CT in PA lateralization.
评估培替沙氟正电子发射断层扫描/计算机断层扫描（Pentixafor PET/CT）对单侧原发性醛固酮增多症（PA）的诊断效能。
检索PubMed和Embase数据库，以识别截至2025年3月发表的相关文章。纳入使用肾上腺静脉采血（AVS）、临床信息、病理及术后随访数据的各种组合作为参考标准，报告培替沙氟正电子发射断层扫描/计算机断层扫描（Pentixafor PET/CT）在识别单侧PA方面诊断准确性的研究。采用双变量随机效应模型确定汇总敏感性、特异性及汇总受试者工作特征曲线下面积（AUC）。我们还纳入了那些既接受过培替沙氟正电子发射断层扫描/计算机断层扫描（Pentixafor PET/CT）又成功进行了肾上腺静脉采血（AVS）的患者的研究。当肾上腺静脉采血（AVS）显示醛固酮分泌在与正电子发射断层扫描/计算机断层扫描（PET/CT）上所见异常相同的一侧单侧增加时，或者当肾上腺静脉采血（AVS）显示醛固酮分泌对称且正电子发射断层扫描/计算机断层扫描（PET/CT）显示双侧或无单侧异常时，正电子发射断层扫描/计算机断层扫描（PET/CT）结果被认为与肾上腺静脉采血（AVS）结果一致。
七项研究共603例患者符合评估诊断准确性的标准。培替沙氟正电子发射断层扫描/计算机断层扫描（Pentixafor PET/CT）在识别单侧PA方面的汇总敏感性、特异性和AUC值分别为80%（95%CI，70 - 87%）、91%（95%CI，86 - 94%）和0.91（95%CI，0.89 - 0.94）。五项研究共189例患者符合评估培替沙氟正电子发射断层扫描/计算机断层扫描（Pentixafor PET/CT）与肾上腺静脉采血（AVS）结果一致性的标准。正电子发射断层扫描/计算机断层扫描（PET/CT）结果与肾上腺静脉采血（AVS）结果一致的患者比例为79.3%（150/189）。
这项荟萃分析表明，培替沙氟正电子发射断层扫描/计算机断层扫描（Pentixafor PET/CT）在识别单侧PA方面具有较高的诊断准确性。此外，在指示醛固酮分泌过多的左侧或右侧，或无侧别化方面，培替沙氟正电子发射断层扫描/计算机断层扫描（Pentixafor PET/CT）结果也与肾上腺静脉采血（AVS）结果高度一致。这些结果证实了培替沙氟正电子发射断层扫描/计算机断层扫描（Pentixafor PET/CT）在PA侧别化方面的前景。
