The following is a summary of “Value of Targeting CXCR4 With 68Ga-Pentixafor PET/CT for Subtyping Primary Aldosteronism,” published in the January 2024 issue of Endocrinology by Zheng, et al.
For a study, researchers sought to assess the efficacy of 68Ga-Pentixafor positron emission tomography/computed tomography (PET/CT) in categorizing primary aldosteronism (PA) and aiding clinical treatment decisions, with a larger sample size.
They enrolled 120 patients diagnosed with either PA or nonfunctional adenoma (NFA) and subjected them to 68Ga-Pentixafor PET/CT. Among them, 11 patients underwent adrenal venous sampling (AVS), 77 underwent adrenalectomy, 76 received pathological diagnoses, and 71 underwent immunohistochemical detection of aldosterone synthase (CYP11B2). Additionally, immunohistochemistry for C-X-C chemokine receptor 4 (CXCR4) was performed in 62 cases. Follow-up was conducted for all patients.
Of the 120 patients, 66 had aldosterone-producing adenoma (APA), 33 had idiopathic hyperaldosteronism (IHA), and 21 had NFA. Visual analysis using 68Ga-Pentixafor PET/CT showed sensitivity, specificity, and accuracy of 92.40%, 94.40%, and 93.33%, respectively, for APA patients. In APA patients with nodules larger than 1 cm, a maximum standard uptake value of 7.3 or higher resulted in 100% specificity, while those with nodules smaller than 1 cm exhibited high sensitivity. AVS, conducted in 5 patients, showed a 60% concordance rate with 68Ga-Pentixafor PET/CT for PA subtyping. Among the 77 patients undergoing adrenalectomy, all 61 with positive lesions on PET/CT benefited from surgery. The concordance rate between 68Ga-Pentixafor PET/CT imaging and CYP11B2 was 81.69%.
68Ga-Pentixafor PET/CT emerged as a reliable and noninvasive functional imaging tool, demonstrating high accuracy in categorizing PA and providing valuable guidance for clinical treatment decisions.
Reference: academic.oup.com/jcem/article-abstract/109/1/171/7227529