Molecular Imaging Versus Adrenal Vein Sampling for the Detection of Surgically Curable Primary Aldosteronism : A Prospective Within-Patient Trial
Authors' conclusion
Molecular imaging is an accurate, noninvasive alternative to AVS.
Study context
- Population
- Patients with primary aldosteronism (PA) desiring surgery if a unilateral source of PA was diagnosed, 3 referral centres
- Participants
- 169 / 169 / 31
- Comparison
- Post-dexamethasone [11C]MTO PET-CT vs adrenal vein sampling (AVS) for predicting outcomes of unilateral adrenalectomy
- [11C]MTOn = 169
- AVSn = 169reference
- [18F]CETOn = 31
- Outcome
- Accuracy for complete or partial biochemical success
Methodological detailsprospective within-patient comparison, three referral centres, noninferiority, Accuracy of [11C]MTO assessable only in the surgical group
- Prospective within-patient comparison
- Three referral centres
- Noninferiority
- Accuracy of [11C]MTO assessable only in the surgical group
Performance
As reported in the abstract
CIs crossed zero (superiority excluded) but not prespecified lower bound of −17%: [11C]MTO noninferior to AVS
Further findings
| Outcome | [11C]MTO | AVS | κ (CI) |
|---|---|---|---|
| Predicted unilateral PA | 52.7% | 46.2% | |
| Agreement of [18F]CETO and [11C]MTO[18F]CETO vs [11C]MTO · agreed in 29 of 31 patients | 0.85 (0.68–1.00) |
- Predicted unilateral PA — Predicted unilateral by both
- 43 of 169 (25.4%)
- Predicted unilateral PA — Assigned to adrenalectomy
- 100 of 169 (59.1%)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Molecular Imaging Versus Adrenal Vein Sampling for the Detection of Surgically Curable Primary Aldosteronism : A Prospective Within-Patient Trial. Ann Intern Med. Published 4 March 2025. doi:10.
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