Avoiding False Negatives: Importance of Early ⁶⁸ Ga Pentixafor PET-CT Acquisition in Primary Aldosteronism Evaluation

Primary aldosteronism (PA) is a prevalent cause of secondary hypertension, and accurate subtyping into unilateral aldosterone-producing adenoma (APA) versus bilateral adrenal hyperplasia is critical, as the former warrants surgical intervention while the latter is managed medically. C-X-C Chemokine receptor type 4 (CXCR4) targeted imaging with 68 Ga Pentiaxfor PET-CT has emerged as a promising non-invasive modality for PA subtyping, leveraging the high CXCR4 expression characteristic of APAs. However, optimal scan acquisition timing following radiopharmaceutical injection remains unstandardised across published literature, with studies reporting imaging performed between 10 and 60 minutes post-injection. This case highlights the need for an early Ga-68 Pentixafor PET-CT imaging for primary aldosteronism evaluation to avoid false negative scans.