nach oben

European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

23.03.2020 | Original Article

Imaging CXCR4 expression in patients with suspected primary hyperaldosteronism

verfasst von: Jie Ding, Yushi Zhang, Jin Wen, Hui Zhang, Huiping Wang, Yaping Luo, Qingqing Pan, Wenjia Zhu, Xuezhu Wang, Shaobo Yao, Michael C. Kreissl, Marcus Hacker, Anli Tong, Li Huo, Xiang Li

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 11/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

It is challenging to differentiate unilateral aldosterone-producing adenoma (APA) from bilateral idiopathic adrenal hyperplasia (IAH) and nonfunctional adrenal adenoma (NFA) in primary aldosteronism (PA). In a first primarily ex vivo study detection, CXC chemokine receptor type 4 (CXCR4) expression has been shown to be a valuable tool for the detection of APA. In this study, we aimed to clinically evaluate CXCR4 imaging with ⁶⁸Ga-pentixafor PET/CT for detecting APA.

Methods

We prospectively recruited 36 patients with clinical suspicion of PA. All patients underwent ⁶⁸Ga-pentixafor PET/CT. Positive lesions were defined based on higher tracer uptake in adrenal nodular(s) shown on CT than the normal adrenal. These lesions were referred for adrenalectomy subsequently. All patients received clinical follow-up. Semi-quantitative analysis using maximum standardized uptake value (SUV_max), lesion-to-liver ratio (LLR), and lesion-to-contralateral ratio (LCR) has also been performed. PET/CT results were correlated with clinical presentation and follow-up.

Results

Thirty-nine adrenal lesions in 36 patients were found; 25 APA, 4 IAH, and 10 NFA according to histopathology and clinical assessment. Sensitivity, specificity, and accuracy of ⁶⁸Ga-pentixafor PET/CT in distinguishing APA by visualization were 100%, 78.6%, and 92.3% respectively. The SUV_max of APA (21.34 ± 9.41, n = 25) was significantly higher than that of non-APA lesions (6.29 ± 2.10, n = 14, P < 0.0001). An optimal threshold of SUV_max = 11.18 was determined for predicting APA with a sensitivity of 88.0%, specificity of 100%, and an accuracy of 92.3%. A cutoff value for LCR of 2.12 yielded a sensitivity of 100% and a specificity of 92.9%, whereas a cutoff value for LLR of 2.36 reached at both 100% of sensitivity and specificity. All patients with (removed) positive lesions benefited from surgery.

Conclusion

⁶⁸Ga-Pentixafor PET/CT may be used to non-invasively detect APA in PA patients.

Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(5):1889–916.CrossRefPubMed

Monticone S, D’Ascenzo F, Moretti C, Williams TA, Veglio F, Gaita F, et al. Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2018;6(1):41–50.CrossRefPubMed

Monticone S, Burrello J, Tizzani D, Bertello C, Viola A, Buffolo F, et al. Prevalence and clinical manifestations of primary aldosteronism encountered in primary care practice. J Am Coll Cardiol. 2017;69(14):1811–20.CrossRefPubMed

Li LL, Gu WJ, Dou JT, Yang GQ, Lv ZH, et al. Incidental adrenal enlargement: an overview from a retrospective study in a Chinese population. Int J Endocrinol. 2015;2015:192874.PubMedPubMedCentral

Nanba AT, Nanba K, Byrd JB, Shields JJ, Giordano TJ, Miller BS, et al. Discordance between imaging and immunohistochemistry in unilateral primary aldosteronism. Clin Endocrinol. 2017;87(6):665–72.CrossRef

Rossi GP. Update in adrenal venous sampling for primary aldosteronism. Curr Opin Endocrinol Diabetes Obes. 2018;25(3):160–71.CrossRefPubMed

Okamura K, Okuda T, Shirai K, Abe I, Kobayashi K, Ishii T, et al. Persistent primary aldosteronism despite iatrogenic adrenal hemorrhage after adrenal vein sampling. J Clin Med Res. 2018;10(1):66–71.CrossRefPubMed

Layden BT, Hahr AJ, Elaraj DM. Primary hyperaldosteronism: challenges in subtype classification. BMC Res Notes. 2012;5:602.CrossRefPubMedPubMedCentral

Powlson AS, Gurnell M, Brown MJ. Nuclear imaging in the diagnosis of primary aldosteronism. Curr Opin Endocrinol Diabetes Obes. 2015;22(3):150–6.PubMedPubMedCentral

10.

Heinze B, Fuss CT, Mulatero P, Beuschlein F, Reincke M, Mustafa M, et al. Targeting CXCR4 (CXC chemokine receptor type 4) for molecular imaging of aldosterone-producing adenoma. Hypertension. 2018;71(2):317–25.PubMed

11.

Walenkamp AME, Lapa C, Herrmann K, Wester HJ. CXCR4 ligands: the next big hit? J Nucl Med. 2017;58(Suppl 2):77S–82S.PubMed

12.

Williams TA, Lenders JWM, Mulatero P, Burrello J, Rottenkolber M, Adolf C, et al. Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort. Lancet Diabetes Endocrinol. 2017;5(9):689–99.PubMedPubMedCentral

13.

Itcho K, Oki K, Kobuke K, Yoshii Y, Ohno H, Yoneda M, et al. Aberrant G protein-receptor expression is associated with DNA methylation in aldosterone-producing adenoma. Mol Cell Endocrinol. 2018;461:100–4.PubMed

14.

O’Shea PM, Griffin TP, Denieffe S, Fitzgibbon MC. The aldosterone to renin ratio (ARR) in the diagnosis of primary aldosteronism (PA): promises and challenges. Int J Clin Pract. 2019;73(7):e13353.PubMed

15.

Käyser SC, Dekkers T, Groenewoud HJ, van der Wilt GJ, Carel Bakx J, van der Wel MC, et al. Study heterogeneity and estimation of prevalence of primary aldosteronism: a systematic review and meta-regression analysis. J Clin Endocrinol Metab. 2016;101(7):2826–35.PubMed

16.

Young WF, Stanson AW, Thompson GB, Grant CS, Farley DR, van Heerden JA. Role for adrenal venous sampling in primary aldosteronism. Surgery. 2004;136(6):1227–35.PubMed

17.

Yen RF, Wu VC, Liu KL, Cheng MF, Wu YW, Chueh SC, et al. 131I-6beta-iodomethyl-19-norcholesterol SPECT/CT for primary aldosteronism patients with inconclusive adrenal venous sampling and CT results. J Nucl Med. 2009;50(10):1631–7.PubMed

18.

Wang T, Satoh F, Morimoto R, Nakamura Y, Sasano H, Auchus RJ, et al. Gene expression profiles in aldosterone-producing adenomas and adjacent adrenal glands. Eur J Endocrinol. 2011;164(4):613–9.CrossRefPubMedPubMedCentral

19.

Burton TJ, Mackenzie IS, Balan K, Koo B, Bird N, Soloviev DV, et al. Evaluation of the sensitivity and specificity of (11)C-metomidate positron emission tomography (PET)-CT for lateralizing aldosterone secretion by Conn’s adenomas. J Clin Endocrinol Metab. 2012;97(1):100–9.CrossRefPubMed

20.

Mendichovszky IA, Powlson AS, Manavaki R, Aigbirhio FI, Cheow H, Buscombe JR, et al. Targeted molecular imaging in adrenal disease-an emerging role for metomidate PET-CT. Diagnostics (Basel). 2016;6(4). https://doi.org/10.3390/diagnostics6040042.

21.

Kreissl MC, Schirbel A, Fassnacht M, Haenscheid H, Verburg FA, Bock S, et al. [(1)(2)(3)I]Iodometomidate imaging in adrenocortical carcinoma. J Clin Endocrinol Metab. 2013;98(7):2755–64.PubMed

22.

Hahner S, Kreissl MC, Fassnacht M, Haenscheid H, Bock S, Verburg FA, et al. Functional characterization of adrenal lesions using [123I]IMTO-SPECT/CT. J Clin Endocrinol Metab. 2013;98(4):1508–18.PubMed

23.

Nanba K, Tsuiki M, Sawai K, Mukai K, Nishimoto K, Usui T, et al. Histopathological diagnosis of primary aldosteronism using CYP11B2 immunohistochemistry. J Clin Endocrinol Metab. 2013;98(4):1567–74.PubMed

Titel: Imaging CXCR4 expression in patients with suspected primary hyperaldosteronism
verfasst von: Jie Ding
Yushi Zhang
Jin Wen
Hui Zhang
Huiping Wang
Yaping Luo
Qingqing Pan
Wenjia Zhu
Xuezhu Wang
Shaobo Yao
Michael C. Kreissl
Marcus Hacker
Anli Tong
Li Huo
Xiang Li
Publikationsdatum: 23.03.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 11/2020
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-020-04722-0

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Imaging CXCR4 expression in patients with suspected primary hyperaldosteronism

Abstract

Purpose

Methods

Results

Conclusion

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2020

FDG PET/CT evaluation of a patient recovering from COVID-19

Imaging and monitoring HER2 expression in breast cancer during trastuzumab therapy with a peptide probe 99mTc-HYNIC-H10F

Fracture risk and survival outcomes in metastatic castration-resistant prostate cancer patients sequentially treated with abiraterone acetate and RADIUM-223

Suppression of myocardial glucose metabolism in FDG PET/CT: impact of dose variation in heparin bolus pre-administration

68Ga-PSMA Cerenkov luminescence imaging in primary prostate cancer: first-in-man series

Reply to comment by J.P. Suarez Fernandez on “Consensus document for the diagnosis of prosthetic joint infections: a joint paper by the EANM, EBJIS, and ESR (with ESCMID endorsement)”