|Title:||131I-6β-iodomethyl-19-norcholesterol SPECT/CT for primary aldosteronism patients with inconclusive adrenal venous sampling and CT results||Authors:||Yen R.-F.
|Issue Date:||2009||Journal Volume:||50||Journal Issue:||10||Start page/Pages:||1631-1637||Source:||Journal of Nuclear Medicine||Abstract:||
The 2 main causes of primary aldosteronism(PA) are aldosteroneproducing adenoma (APA) and idiopathic adrenal hyperplasia (IAH). Dexamethasone- suppression 131I-6β-iodomethyl-19-norcholesterol (NP-59) adrenal scintigraphy can assess the functioning of the adrenal cortex. This study evaluated the diagnostic usefulness of NP-59 SPECT/CT in differentiating APA from IAH and in predicting postadrenalectomy clinical outcome for PA patients who had inconclusive adrenal venous sampling (AVS) and CT results. Methods:Weretrospectively reviewed the 31 adrenal lesions of 27 patients (age range, 33-71 y; mean age ± SD, 50.4 ± 10.9 y) who had been clinically confirmed (by saline infusion and captopril tests) to have PA, had inconclusive CT and AVS test results, and had undergone NP-59 imaging before adrenalectomy. The accuracy of NP-59 imaging was determined by comparison with histopathologic findings. Results: NP-59 SPECT/CT gave us 18 true-positive, 3 false-positive, 6 true-negative, and 4 false-negative results. Compared with planar imaging, SPECT/CT significantly improved diagnostic accuracy and prognostic predicting ability (P = 0.0390 and P = 0.0141, respectively). The NP-59 results were negative for 7 of the 23 patients with unilateral adrenal lesions, and none of these 7 patients had shown postsurgical clinical improvement. Conclusion: NP-59 SPECT/CT is an effective imaging tool for differentiating APA from IAH in PA patients whose CT and AVS results are inconclusive. Our results suggest that patients with presurgically negative NP-59 results should be treated medically and that noninvasive NP-59 SPECT/CT may be suited for use as the first lateralization modality after CT in patients with clinically confirmed PA. Copyright ? 2009 by the Society of Nuclear Medicine, Inc.
|ISSN:||0161-5505||DOI:||10.2967/jnumed.109.064873||metadata.dc.subject.other:||6beta iodomethyl 19 norcholest 5(10) en 3beta ol i 131; dexamethasone; np 69; unclassified drug; 6 iodomethylcholesterol; 6-iodomethylcholesterol; diagnostic agent; drug derivative; iodocholesterol; adrenal hyperplasia; adrenal scintiscanning; adrenal suppression; adrenalectomy; adult; aged; article; clinical article; computer assisted tomography; diagnostic accuracy; diagnostic value; differential diagnosis; false negative result; false positive result; female; histopathology; human; male; preoperative evaluation; primary hyperaldosteronism; priority journal; retrospective study; single photon emission computer tomography; adenoma; adrenal gland; computer assisted tomography; hyperaldosteronism; hyperplasia; middle aged; pathology; pathophysiology; radiography; scintiscanning; sensitivity and specificity; single photon emission computer tomography; treatment outcome; vascularization; vein; 19-Iodocholesterol; Adenoma; Adrenal Glands; Adrenalectomy; Adult; Aged; Diagnosis, Differential; Female; Humans; Hyperaldosteronism; Hyperplasia; Male; Middle Aged; Retrospective Studies; Sensitivity and Specificity; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Treatment Outcome; Veins
|Appears in Collections:||醫學系|
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