Pd23-03 Role of ⁶⁸ Ga-Pentixafor Pet/Ct Targeting Cxcr4 in Assisting the Surgical Strategy of Primary Aldosteronism

You have accessJournal of UrologyAdrenal (PD23)1 May 2024PD23-03 ROLE OF 68GA-PENTIXAFOR PET/CT TARGETING CXCR4 IN ASSISTING THE SURGICAL STRATEGY OF PRIMARY ALDOSTERONISM Guoyang Zheng, Yushi Zhang, and Li Huo Guoyang ZhengGuoyang Zheng , Yushi ZhangYushi Zhang , and Li HuoLi Huo View All Author Informationhttps://doi.org/10.1097/01.JU.0001008664.51020.58.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Primary aldosteronism (PA) is considered as the most common cause of secondary hypertension, and the identification of functional lesions and endocrine lateralization is crucial for surgery of PA. However, it is sometimes difficult to distinguish APAs from hyperplasia nodules or nonfunctioning adrenal adenomas. We aimed to investigate the role of 68Ga-pentixafor PET/CT in assisting the surgical strategy for PA, which was a novel nuclide imaging method targeting CXCR4 to detect aldosterone-producing adrenal lesions. METHODS: The clinical characteristics and postoperative outcomes of 91 PA patients were retrospectively analyzed, confirmed by CT imaging, aldosterone concentration / rennin activity ratio and captopril challenge test. All patients received operations according to results of 68Ga-pentixafor PET/CT. Evaluation criteria of postoperative outcomes referred to Primary Aldosteronism Surgical Outcomes classification system (PASO). RESULTS: The positive rate of 68Ga-pentixafor PET/CT in 91 PA patients was 85.7% (78/91), and the median maximum standardized uptake value (SUVmax) was 10.2(6.0-16.0). The SUVmax was positively correlated with lesion diameter (r=0.497, p<0.001), while was negatively correlated with blood potassium level (r=-0.450, p<0.001) and plasma renin activity (r=-0.297, p=0.004). The positive rate of 73 PA patients with simple adrenal lesion was 86.3% (63/73). After operations, 95.2% of positive cases (60/63) acquired clinical benefit after operations, including 27 cases cured, 33 cases improved. For patients with simple positive lesion, the preoperative median SUVmax in cured patients was higher than that in improved patients after operations (15.2(8.5-22.4) vs 9.9(7.7-13.9), p=0.037). Under the guidance of 68Ga-pentixafor PET/CT, 13 of 18 PA patients with multiple adrenal lesions acquired clinical benefit after operations, including 9 cases cured and 4 cases improved. The accuracy rate of 68Ga-pentixafor PET/CT in identifying endocrine function lateralization for PA patients was 85.7%, no significant difference with the 71.4% of AVS. CONCLUSIONS: 68Ga-pentixafor PET/CT presented high positive rate in PA patients, and the SUVmax was correlated with lesion diameter, blood potassium level and plasma renin activity. 68Ga-pentixafor PET/CT could effectively assist the surgical strategy of PA patients with high clinical benefit rate, and could accurately identify the lateralization of endocrine function, not inferior to AVS. Source of Funding: This work was supported by National High Level Hospital Clinical Research Funding (2022-PUMCH-B-010) © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e524 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Guoyang Zheng More articles by this author Yushi Zhang More articles by this author Li Huo More articles by this author Expand All Advertisement PDF downloadLoading ...