The prognostic value of CXCR4 PET/CT imaging in unilateral primary aldosteronism patients after adrenalectomy

• Published in: EJNMMI research Vol. 15; no. 1; pp. 41 - 12
• Main Authors: Shao, Shuai, Xu, Haozhe, Xing, Zhuo, Hong, Yulong, Yin, Xuan, Luo, Jianguang, Ai, Kai, Su, Xin, Ma, Xiaowei, Li, Yuan
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 17.04.2025; Springer Nature B.V; SpringerOpen
• Subjects: Adrenalectomy; Blood pressure; Cardiac Imaging; Clinical outcome; Computed tomography; CXCR4 PET/CT; Imaging; Medical imaging; Medicine; Medicine & Public Health; Nuclear Medicine; Oncology; Original Research; Orthopedics; Positron emission; Pressure recovery; Primary aldosteronism; Radiology; Adrenalectomy; Clinical outcome; CXCR4 PET/CT; Primary aldosteronism
• ISSN: 2191-219X; 2191-219X
• DOI: 10.1186/s13550-025-01242-6

Background CXCR4 PET/CT imaging has emerged as a tool for diagnosis and subtyping of primary aldosteronism (PA). But its prognostic value for postoperative blood pressure recovery has not been fully discussed. Results The lesional SUVmax to the contralateral adrenal tissue SUVmean ratio (LCR) was identified as an independent predictor of clinical success at both the 3-month and 6-month assessments. The AUC for LCR was 0.894 at the 3-month and 0.832 at the 6-month. Patients were divided into high and low LCR groups according to the optimal cut-off of 3.240. The high LCR group exhibited elevated CXCR4 and CYP11B2 expression, higher PAC level, a greater probability of achieving complete clinical success compared to the low LCR group. Moreover, LCR was correlated with lateralization index and contralateral suppression index. Conclusions LCR is a reliable independent predictor of postoperative blood pressure recovery in PA. Patients with LCR over 3.240 may benefit more from adrenalectomy. We recommend increased utilization of CXCR4 PET/CT for patients with PA. Registration ChiCTR2200062844. Registered 20 August 2022.