C-X-C Motif Chemokine Receptor 4–Directed Scintigraphy Using [ 99m Tc]Tc-Pentixatec in Primary Aldosteronism: A Proof-of-Concept Study

• Published in: Journal of Nuclear Medicine Vol. 65; no. 10; pp. 1640 - 1644
• Main Authors: Enke, Johanna S., Ritzel, Kathrin, Asbach, Evelyn, Reitsam, Nic G., Märkl, Bruno, Knösel, Thomas, Brüdgam, Denise, Kircher, Malte, Pfob, Christian H., Bundschuh, Ralph A., Rinscheid, Andreas, Nittbaur, Bernd, Wienand, Georgine, Schottelius, Margret, Reincke, Martin, Lapa, Constantin, Dierks, Alexander
• Format: Journal Article
• Language: English
• Published: United States Society of Nuclear Medicine 01.10.2024
• Subjects: Adrenalectomy; Aldosterone; Chemokine receptors; Chemokines; Computed tomography; CXCR4 protein; Feasibility studies; Lesions; Medical imaging; Positron emission; Remission; Scintigraphy; Single photon emission computed tomography; scintigraphy; CXCR4-directed imaging; primary aldosteronism
• ISSN: 0161-5505; 2159-662X; 1535-5667
• DOI: 10.2967/jnumed.124.268169

C-X-C motif chemokine receptor 4 (CXCR4)-directed imaging has gained clinical interest in aiding clinical diagnostics in primary aldosteronism (PA). We retrospectively evaluated the feasibility of CXCR4-directed scintigraphy using the novel CXCR-4 ligand [ Tc]Tc-pentixatec in patients with PA. Six patients (mean age ± SD, 49 ± 15 y) underwent CXCR4-directed scintigraphy (including planar imaging and SPECT/CT) 30, 120, and 240 min after injection of 435 ± 50 MBq of [ Tc]Tc-pentixatec. Adrenal CXCR4 expression was analyzed by calculating lesion-to-contralateral ratios (LCRs). Imaging results were correlated to clinical information. Histopathology and clinical follow-up served as the standard of reference. Three subjects showed lateralization of adrenal tracer accumulation, with a mean maximum lesion-to-contralateral ratio of 1.65 (range, 1.52-1.70), which correlated with morphologic findings on CT. One individual underwent adrenalectomy and presented with complete biochemical and clinical remission at follow-up. Histopathologic workup confirmed unilateral aldosterone-producing adenoma. [ Tc]Tc-pentixatec scintigraphy with SPECT in patients with PA is feasible and might offer a valuable alternative to CXCR4-directed imaging with [ Ga]Ga-pentixafor PET.