The final, formatted version of the article will be published soon.
ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Adrenal Endocrinology
Volume 16 - 2025 |
doi: 10.3389/fendo.2025.1533295
This article is part of the Research Topic Enhancing Adrenal Tumor Diagnostics: Biomarkers and Molecular Mechanisms View all 8 articles
The Value of Targeted CXCR4 18 F-AlF-NOTA-Pentixafor PET/CT for Subtyping Primary Aldosteronism
Provisionally accepted
Yushi Peng 1* Fangansheng Chen 1* Rui Yao 1* Junping Lan 1* Yinuo Fu 2* Kaifeng Ye 2* Zhiqiang Wang 1*
Xiaowei Ji 1 Guoqing Zhu 1* Kewen Zheng 1* Xuemei Gu 1*
Kun Tang 1*- 1 First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- 2 Wenzhou Medical University, Wenzhou, Zhejiang Province, China
Objective The study aimed to investigate the diagnostic value of 18F-AlF-NOTA-Pentixafor PET/CT in subtyping primary aldosteronism (PA).Methods This study enrolled 88 patients with PA or nonfunctional adenoma (NFA) for 18F-Pentixafor PET/CT scan. Of these, 20 patients underwent adrenal venous sampling (AVS), and 65 underwent adrenalectomy and postoperative follow-up.Results In 88 patients, 76 were diagnosed with unilateral PA (UPA), 4 were diagnosed with bilateral PA (BPA), and 8 were diagnosed with NFA, resulting in a total of 95 lesions. To identify UPA, visual analysis received a specificity of 94.12% and a sensitivity of 87.18%. The optimal cutoff values for SUVmax at 5.45, the lesion-to-normal adrenal ratio (LAR) at 1.43, and lesion-to-liver ratio (LLR) all yielded a specificity of 100% and a sensitivity of 79.49%, 83.33%, and 80.77%, respectively. In 17 adrenal lesions with similar uptake to contralateral and adjacent normal adrenal tissue (defined as warm lesions), 9 were confirmed as UPA, 4 were confirmed as BPA, and 4 were confirmed as NFA. Furthermore, among the 20 patients who underwent AVS, the concordance rate of AVS and PET/CT visual analysis for PA subtyping was 65.00%.Conclusions The CXCR4-targeted 18F-AlF-NOTA-pentixafor PET/CT is a valuable noninvasive tool for diagnosing UPA, demonstrating high sensitivity and specificity. More attention should be paid to warm adrenal lesions for their high diagnostic ambiguity probability.
Keywords: primary aldosteronism, CXCR4, 18 F-pentixafor, PET/CT, subtyping, Treatment
Received: 23 Nov 2024; Accepted: 07 Feb 2025.
Copyright: © 2025 Peng, Chen, Yao, Lan, Fu, Ye, Wang, Ji, Zhu, Zheng, Gu and Tang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yushi Peng, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Fangansheng Chen, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Rui Yao, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Junping Lan, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Yinuo Fu, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China
Kaifeng Ye, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China
Zhiqiang Wang, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Guoqing Zhu, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Kewen Zheng, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Xuemei Gu, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Kun Tang, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.