Typing diagnostic value of 68Ga-pentixafor PET/CT for patients with primary aldosteronism and unilateral nodules

Purpose: Our goal was to compare the lateralization of Ga-68-pentixafor PET/CT with adrenal vein sampling (AVS) in primary aldosteronism (PA) patients with unilateral lesions. Methods: We retrospectively enrolled 61 patients with PA and all patients showed unilateral nodular lesions on CT and underwent Ga-68-Pentixafor PET/CT. The general clinical data, imaging and AVS results were collected. The diagnostic efficiency of Ga-68-Pentixafor PET/CT imaging in PA patients was calculated by visual and semi-quantitative analysis to compare the consistency with AVS, and the correlation between CXCR4 express and Ga-68-Pentixafor uptake was performed. R<strong style="background-color:inherit">esults:<strong style="background-color:inherit"> <span style="background-color:inherit">The study included 42 unilateral PA (UPA) and 19 bilateral PA (BPA). The area under curve (AUC) of </span>68</SUP><span style="background-color:inherit">Ga-Pentixafor PET/CT to diagnosis UPA with 10 min maximum standardized uptake value (SUVmax) > 8.17 was 0.82 ([0.70-0.90], P < 0.001), and the sensitivity and specificity were 0.64 and 0.90, respectively. The maximal AUC of </span>68</SUP><span style="background-color:inherit">Ga-pentixafor PET/CT for the diagnosis UPA in patients with nodules with a diameter >= 1 cm was 0.87 ([0.73-0.95],P both <0.001,[10 min SUVmax=8.17 and 10 min mean standardized uptake value (SUVmean)=5.57]), and the sensitivity and specificity were 0.73 and 0.93, respectively. Unilateral adrenalectomy and significant CXCR4 expression were present in 32 UPA, including 27 aldosterone-producing adenoma and 5 idiopathic adrenal hyperplasia. Additionally, </span>68</SUP><span style="background-color:inherit">Ga-pentixafor uptake in adrenal lesions was significantly correlated with CXCR4 expression, and statistical differences in </span>68</SUP><span style="background-color:inherit">Ga-pentixafor uptake among IRS subgroups.</span> Conclusions: Ga-68-Pentixafor PET/CT can be helpful for subtyping diagnosis of PA patients with unilateral adrenal nodular, showing significant potential in non-invasive PA classification