Clinical value of 68Ga-pentixafor PET/CT in patients with primary aldosteronism and bilateral lesions: preliminary results of a single-centre study.

Abstract

Background: Subtype diagnosis of primary aldosteronism (PA) is used to determine treatment, and the potential utility of ⁶⁸Ga-pentixafor PET/CT for investigation of PA has long been recognized. The study aimed to evaluate the clinical value of ⁶⁸Ga-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 ⁶⁸Ga-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 ⁶⁸Ga-Pentixafor PET/CT and adrenal venous sampling was 65.2% (15/23). The lateralization results of ⁶⁸Ga-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 ⁶⁸Ga-Pentixafor uptake was correlated with KCNJ5 gene status.

Conclusions: ⁶⁸Ga-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 ⁶⁸Ga-Pentixafor PET/CT and KCNJ5 gene status, warranting further analysis.