Application value of PET/CT in functional localization diagnosis of primary aldosteronism
Objective:To investigate the clinical value of CXC chemokine receptor type 4(CXCR4)-targeting 68Ga-Pentixafor positron emission tomography/computed tomography(PET/CT)radionuclide-based imaging in the functional localization of the dominant side and prognosis of primary aldosteronism(PA).Methods:A total of 66 inpatients diagnosed with PA in The First Affiliated Hospital of Chongqing Medical University from March 2022 to May 2023 were selected.All patients were examined by PET/CT and adrenal vein sampling(AVS),and underwent unilateral or partial laparoscopic adrenalectomy.The coincidence rate of PET/CT and AVS in the diag-nosis of PA lateralizationwas analyzed and compared.According to the improvement in blood pressure,medication,and blood potas-sium level during postoperative follow-up,the accuracy rate of functional localization diagnosis on the dominant side of PA by PET/CT and the predictive value of maximum standardized uptake value(SUVmax)of lesions for postoperative prognosis of patients were evalu-ated.Results:Among the 66 surgical patients,unilateral adrenalectomy was performed in 63 patients and partial adrenalectomy in 3 patients.Postoperative pathological examinations showed adenoma in 58 patients and hyperplasia in 8 patients.The coincidence rate of PET/CT and AVS in the diagnosis of PA lateralization was 83.3％(55/66).Based on the postoperative clinical benefit,the accuracy rates of PET/CT and AVS in the functional localization diagnosis of the dominant side of PA were 88.14％(52/59)and 93.22％(55/59),respectively.SUVmax in postoperative cured patients[14.70(8.75,19.45)]was significantly higher than that in postoperative improved patients[10.90(6.65,14.10)](P=0.026).Preoperative SUVmax was positively correlated with postoperative aldosterone decrease,aldosterone/renin ratio decrease,and serum potassium increase(r=0.267,0.365,and 0.392,P=0.034,0.003,and 0.001,respectively).Conclusion:CXCR4-targeting 68Ga-Pentixafor PET/CT for localization diagnosis of the dominant side of PA has an accu-racy rate close to that of AVS,but with the advantages of repeatability and non-invasiveness.The higher the SUVmax,the more obvious the postoperative clinical benefit,showing a certain prognostic value.
万方数据
维普
