Does molecular imaging provide an accurate alternative to adrenal vein sampling for the detection of surgically curable primary aldosteronism in patients with PA?
Molecular imaging is an accurate, noninvasive alternative to adrenal vein sampling for detecting surgically curable primary aldosteronism.
BACKGROUND: Primary aldosteronism (PA) causes hypertension and is potentially surgically curable when it is caused by a unilateral aldosterone-producing adrenal adenoma (APA). Adrenal vein sampling (AVS) is required to guide surgery, but it is invasive, is technically difficult, and has limited availability. OBJECTIVE: F]CETO). DESIGN: Prospective within-patient comparison of diagnostic interventions. (ClinicalTrials.gov: NCT02945904). SETTING: Three referral centers. PARTICIPANTS: 174 patients with PA desiring surgery if a unilateral source of PA was diagnosed. INTERVENTION: F]CETO in the final 31. MEASUREMENTS: F]CETO. RESULTS: C]MTO agreed in 29 of 31 patients (κ = 0.85 CI, 0.68 to 1.00). LIMITATION: C]MTO could be assessed only in the surgical group. CONCLUSION: Molecular imaging is an accurate, noninvasive alternative to AVS. PRIMARY FUNDING SOURCE: National Institute for Health and Care Research.
Goodchild et al. (Sat,) studied this question.