Clinical Utility of Dual‐Time 68 Ga‐Pentixafor PET/CT in Diagnosing and Subtyping Primary Aldosteronism
Authors' conclusion
Dual-time 68Ga-pentixafor PET/CT exhibits robust diagnostic efficacy in PA lateralization. Furthermore, 68Ga-pentixafor PET/CT holds promise as an imaging marker for predicting the presence of the KCNJ5 mutation in PA patients.
Study context
- Population
- Patients with PA
- Participants
- 161 patients
- Comparison
- Dual-time 68Ga-pentixafor PET/CT vs CT for PA lateralization
- Outcome
- Diagnostic performance for unilateral PA (unilateral primary aldosteronism (UPA)) and aldosterone-producing adenoma (APA)
Methodological detailsdual-time PET/CT
- Dual-time PET/CT
Performance
As reported in the abstract
Diagnostic accuracy for UPA
| Test or model | Value | Accuracy |
|---|---|---|
| 68Ga-pentixafor PET 10 min | 75.2% | 75.2% |
| 68Ga-pentixafor PET 40 min | 76.4% | 76.4% |
| CT | 55.3% | 55.3% |
Value
68Ga-pentixafor PET 10 min75.2%
68Ga-pentixafor PET 40 min76.4%
CT55.3%
Accuracy
68Ga-pentixafor PET 10 min75.2%
68Ga-pentixafor PET 40 min76.4%
CT55.3%
- 68Ga-pentixafor PET 10 min vs CT: P < 0.01 — PET accuracy at 10 and 40 min surpassed CT
Further findings
| Outcome | 68Ga-pentixafor PET 10 min |
|---|---|
| Diagnosis of APA, 10 min lesion-to-normal adrenal ratio cutoff 1.95 | |
| AUC | 91.9% |
| Sensitivity | 76.0% |
| Specificity | 91.3% |
| Accuracy | 83.3% |
Diagnosis of aldosterone-producing adenoma (APA) by nodule size
- Largest AUC, lesions ≥ 1 cm
- 88.2%
- Largest AUC, lesions < 1 cm
- 97.0%
Surgical decision and outcomes
- PET/CT lateralization corroborated surgical treatment decision
- 92.0%
- Clinical and/or biochemical cure or improvement
- more than 95%
KCNJ5 mutation prediction, 40 min lesion-to-liver ratio cutoff 4.79
- AUC
- 81.3%
- Sensitivity
- 90.0%
- Specificity
- 66.7%
- PET positive rate higher in KCNJ5 mutation than wild-type
Original publication
Clinical Utility of Dual‐Time 68 Ga‐Pentixafor PET/CT in Diagnosing and Subtyping Primary Aldosteronism. Clin Endocrinol (Oxf). Published 26 January 2025. doi:10.
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