Primary Aldosteronism Classification With 18-Oxocortisol and Gallium-68–Pentixafor Positron Emission Tomography/Computed Tomography
Authors' conclusion
The LC-MS/MS and 68Ga-pentixafor PET/CT have great advantages on the subtyping of PA. There was a high accuracy of the combination of the 2 methods, which will contribute to avoid an unnecessary adrenal venous sampling operation before surgery for most patients with PA.
Study context
- Population
- Patients with primary aldosteronism (PA): 99 with aldosterone-producing adenoma (APA) and 61 with idiopathic hyperaldosteronism
- Comparison
- 18-oxocortisol (LC-MS/MS) and 68Ga-pentixafor positron emission tomography (PET)/computed tomography (CT), alone or combined, for PA subtyping (APA vs idiopathic hyperaldosteronism)
- Outcome
- Diagnostic accuracy for APA vs idiopathic hyperaldosteronism
Performance
As reported in the abstract
| Test or model | Sensitivity | Specificity |
|---|---|---|
| 18-oxocortisol | 75.3% | 91.2% |
| 68Ga-pentixafor PET/CT visual analysis | 93.7% | 56.3% |
| 68Ga-pentixafor PET/CT SUVmax | 69.8% | 93.7% |
Sensitivity
18-oxocortisol75.3%
68Ga-pentixafor PET/CT visual analysis93.7%
68Ga-pentixafor PET/CT SUVmax69.8%
Specificity
18-oxocortisol91.2%
68Ga-pentixafor PET/CT visual analysis56.3%
68Ga-pentixafor PET/CT SUVmax93.7%
- 18-oxocortisol + PET/CT SUVmax double positive placed in right APA subtype
- 100%
- 18-oxocortisol + PET/CT visual analysis: sensitivity of at least 1 positive
- 95.2%
- 18-oxocortisol + PET/CT visual analysis: classified correctly
- 87.2%
Further findings
Steroid profiling (LC-MS/MS)
- Average levels of 6 steroids apart from aldosterone higher in APA than idiopathic hyperaldosteronism
Original publication
Primary Aldosteronism Classification With 18-Oxocortisol and Gallium-68–Pentixafor Positron Emission Tomography/Computed Tomography. Endocr Pract. Published 25 February 2025. doi:10.
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