Added value of multiparametric MRI for diagnosing subcentimeter functional adrenal nodules in primary aldosteronism using CXCR4-targeted PET/MRI.
Objective: This study aims to evaluate the clinical utility of 68Ga-pentixafor PET/MRI in diagnosing primary aldosteronism (PA) in functional adrenal nodules, with a particular focus on subcentimeter nodules. Additionally, the diagnostic performance of integrated PET/MRI is compared to single-modali...
| Publicado en: | European Journal of Nuclear Medicine & Molecular Imaging Vol. 52; no. 13; pp. 5189 - 5200 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Nov2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=189136503&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 189136503 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16197070 NPC jtl: European Journal of Nuclear Medicine & Molecular Imaging issn: 16197070 maglogo: N pubinfo: dt: Nov2025 vid: 52 iid: 13 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 189136503 186034091 10.1007/s00259-025-07415-8 189136503 ppf: 5189 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Added value of multiparametric MRI for diagnosing subcentimeter functional adrenal nodules in primary aldosteronism using CXCR4-targeted PET/MRI. aug: au: Meng, Xiaoli Quan, Zhiyong Fan, Linni Zhang, Mingru Li, Guiyu Xu, Mengwei Wang, Jia Ma, Wenhui Yang, Weidong Yang, Bo Wang, Jing Kang, Fei affil: https://ror.org/00ms48f15 Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China sug: ab: Objective: This study aims to evaluate the clinical utility of 68Ga-pentixafor PET/MRI in diagnosing primary aldosteronism (PA) in functional adrenal nodules, with a particular focus on subcentimeter nodules. Additionally, the diagnostic performance of integrated PET/MRI is compared to single-modality PET imaging. Methods: A total of 62 patients with clinical suspicion of PA were enrolled from a tertiary hospital in China. Prior to adrenalectomy, all patients underwent 68Ga-pentixafor PET/MRI, followed by CXCR4 and CYP11B2 immunohistochemical analysis post-surgery. Adrenal lesions were stratified into two size groups: ≥ 1 cm and < 1 cm. Quantitative PET parameters, including SUVmax, SUVmean, and lesion-to-liver uptake ratio (LLR), were evaluated alongside MRI parameters such as outphase/inphase signal ratio (OIR), relative percent washout (RPW), T2-weighted image intensity, apparent diffusion coefficient (ADC). Receiver operating characteristic (ROC) curve analysis was performed to establish diagnostic thresholds. Comparative analyses were conducted between single-modality PET and integrated PET/MRI for diagnostic accuracy. Results: Among 62 patients, 74 adrenal lesions were confirmed pathologically, comprising 37 aldosterone-producing adenomas (APA, ≥ 1 cm), 21 aldosterone-producing micronodules (micro-APA, < 1 cm), and 16 non-functioning adenomas (NFA). Key PET/MRI parameters, including SUVmax, SUVmean, LLR, OIR, and RPW, showed significant differentiation between functional adrenal nodules and normal adrenal glands (P < 0.001). For nodules ≥ 1 cm, the PET SUVmax threshold of 7.87 achieved a sensitivity of 92.3% and specificity of 95.0% for APA diagnosis. For nodules < 1 cm, the PET SUVmax threshold of 6.49 yielded a sensitivity of 68.8% and specificity of 83.3% for micro-APA diagnosis. Integrated PET/MRI significantly improved the diagnostic sensitivity for PA subcentimeter nodules from 68.8% (with PET alone) to 87.5%, and increased the area under the ROC curve from 0.760 to 0.854, with no significant reduction in diagnostic specificity. Conclusion: 68Ga-Pentixafor PET/MRI demonstrated high diagnostic accuracy for functional adrenal nodules in PA, particularly enhanced sensitivity for subcentimeter nodules compared to PET alone. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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