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We aimed to investigate the diagnostic and prognostic value of 68Ga-pentixafor PET/CT imaging in noncancer patients with suspected adrenal masses. Methods: Sixty-four patients who had benign adrenal masses on CT were retrospectively included in our study. All patients underwent 68Ga-pentixafor PET/CT, and 56 of these patients subsequently underwent adrenalectomy. The subtypes of 81 adrenal tumors, including 14 nonfunctioning adrenal nodules, 4 cortisol-producing adenomas, 41 aldosterone-producing adenomas, 5 cases of suspected unilateral adrenal hyperplasia, 15 cases of idiopathic aldosterone hyperplasia, and 2 pheochromocytomas, were determined by histology or follow-up evaluations. The diagnostic efficiency of functional lateralization was calculated by visual analysis. Semiquantitative parameters of these lesions, including SUVmax, the ratio of lesional SUVmax to normal liver SUVmean (LLR), and the ratio of lesional SUVmax to contralateral adrenal tissue SUVmean (LCR), were also calculated. Dynamic analysis was also performed on 15 patients. In addition, clinical outcomes were assessed and compared in patients who underwent adrenalectomy. Results: The sensitivity and specificity of 68Ga-pentixafor PET for functional lateralization in patients with adrenocortical lesions were 97.8% (45/46) and 87.5% (14/16), respectively. The 2 pheochromocytoma lesions had lower pentixafor uptake than the normal adrenal glands. Functioning (active) adrenocortical adenomas showed an elevated SUVmax of 16.3 ± 7.9, in comparison to 4.4 ± 1.7 in nonfunctioning (inactive) adenomas and 5.5 ± 2.7 in hyperplasia lesions (P max showed a sensitivity of 90.9% and a specificity of 85.3% (area under receiver-operating-characteristic curve, 0.96; P P P 68Ga-pentixafor were significantly higher in patients with preferable outcomes (cured/improved) (SUVmax, 15.5 ± 8.0; LLR, 6.5 ± 4.3; LCR, 6.2 ± 5.0) than in patients with nonpreferable outcomes (no improvement) (SUVmax, 4.2 ± 0.5; LLR, 1.3 ± 0.2; LCR, 1.5 ± 0.6; all P Conclusion:68Ga-pentixafor PET/CT imaging exhibits great potential for noninvasive functional lateralization and characterization in patients with adrenocortical masses.
Ding et al. (Thu,) studied this question.