Novel PET/CT Technique Accurately Diagnoses Adrenal Gland Disorder

By MedImaging International staff writers
Posted on 22 Jan 2024

Image: A novel imaging approach accurately identifies sub-types of primary aldosteronism (Photo courtesy of 123RF)

Primary aldosteronism is an endocrine disorder characterized by the adrenal glands producing excess aldosterone, often due to nodules on these glands. Elevated aldosterone levels cause the body to retain too much sodium and lose potassium, leading to high blood pressure and increased risks of stroke and heart disease. Accurately distinguishing between surgically treatable and non-treatable forms of primary aldosteronism is crucial for effective treatment planning. Typically, this differentiation is attempted using adrenal CT and adrenal venous sampling, but these methods can be challenging and imprecise, especially for diagnosing adrenal micronodules. Now, an innovative imaging technique has demonstrated superior accuracy in identifying sub-types of primary aldosteronism, offering a more reliable diagnostic alternative than traditional methods. This advanced imaging approach gives a more detailed view of the adrenal glands, aiding physicians in making more informed surgical decisions.

A study by the Chinese Academy of Medical Sciences & Peking Union Medical College Hospital (PUMC-CAMS, Beijing, China) involved 123 patients with adrenal micronodules detected through adrenal CT. These patients were further examined using 68Ga-pentixafor PET/CT, and 104 of them, who either underwent surgery or successful adrenal venous sampling, were included in the final analysis. Nuclear medicine experts evaluated the 68Ga-pentixafor PET/CT data for its sensitivity, specificity, and accuracy, comparing these results with those from adrenal CT and adrenal venous sampling. The 68Ga-pentixafor PET/CT showed significantly higher sensitivity, specificity, and accuracy (90.2%, 72.7%, and 86.5%, respectively) in identifying patients with surgically treatable primary aldosteronism compared to adrenal CT (73.1%, 53.8%, and 68.3%, respectively). Additionally, it outperformed adrenal venous sampling in predicting surgical outcomes, with 82.4% accuracy versus 68.86%.

“The significance of this work lies in its potential to change how we diagnose and treat primary aldosteronism patients with tiny adrenal nodules,” said Li Huo, MD, PhD, professor and chair in the Department of Nuclear Medicine at PUMC-CAMS. “For patients, this means an improved chance of getting the right treatment, especially when it comes to deciding whether surgery is necessary. Accurate diagnosis is crucial because it leads to more effective treatments, less unnecessary surgery and overall better health outcomes. It's about offering patients a more personalized and precise medical approach.”

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PUMC-CAMS