Adrenal Aldosterone Synthase Expression Imaging in Primary Aldosteronism

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  Figure 1. PET-CT and Tissue Imaging in Participant 17 Panel A shows PET overlaid on CT for participant 17 as a static scan from 35-45 min post-administration of the CYP11B2 specific radioligand, which was deemed optimal for diagnostic imaging. The images are displayed with an artificial color scale from 0-10 SUV. Two adrenal lesions were detected by PET-CT in the left adrenal, which was predicted to be dominant by AVS. The left image shows an axial view of the superior microlesion. The middle image shows an axial view of the inferior macroscopic lesion. Excretion of the radiotracer in the renal pelvis can be seen. The right image displays a sagittal view of both adrenal lesions. There was no detectable PET signal in the contralateral adrenal gland or in adrenal tissue surrounding the lesions. Panel B shows radioligand autoradiography (left), and immunohistochemical staining of aldosterone synthase (CYP11B2, middle) and the cortisol-producing enzyme 11β-hydroxylase (CYP11B1, right) performed on directly adjacent sections of the resected adrenal tissue. Radioligand binding was quantified using internal standards in each experiment, and images are displayed on a grey scale representing the…