68Ga-Pentixafor PET/CT for the assessment of therapeutic outcomes following superselective adrenal arterial embolization in patients with primary aldosteronism

Abstract

Abstract Background Superselective adrenal artery embolization (SAAE) represents a novel therapeutic strategy for managing primary aldosteronism (PA). Currently, the evaluation of its efficacy is primarily restricted to clinical indicators, with a notable deficiency in imaging evaluation methodologies. In recent years, several studies have investigated the application of 68Ga-Pentixafor PET/CT for the classification of PA. However, there is a scarcity of specific research investigating the role of PET/CT in the evaluation of efficacy of this condition. Consequently, this study aims to evaluate the therapeutic efficacy of SAAE in patients with PA using 68Ga-Pentixafor PET/CT, with the objective of establishing imaging evaluation methodologies for assessing PA patients post-SAAE treatment. Results Of the 27 patients, 2 achieved complete clinical remission, while 25 experienced partial remission. Biochemically, 13 patients attained complete remission, 13 had partial remission, and 1 did not. For patients with aldosterone-producing adenoma, both visual and semi-quantitative analyses of PET/CT effectively assessed changes in radioactive uptake of the lesion. For idiopathic hyperaldosteronism patients, PET/CT parameters were more effective than visual analysis in evaluating SAAE efficacy. A significant difference in the ΔTLR-40 min parameter was observed across biochemical outcomes (P = 0.041), with patients having ΔTLR-40 min ≥ 0.07 showing better outcomes (AUC = 0.789, P = 0.041). Conclusions 68Ga-Pentixafor PET/CT enables timely assessment of therapeutic outcomes in patients with PA following SAAE, thereby improving clinical decision-making and patient management.

Keywords

• Primary aldosteronism
• 68Ga-Pentixafor
• PET/CT
• Superselective adrenal arterial embolization