Molecular Imaging Versus Adrenal Vein Sampling for the Detection of Surgically Curable Primary Aldosteronism

Emily Goodchild(St Bartholomew's Hospital), Xilin Wu(St Bartholomew's Hospital), Russell Senanayake(University of Cambridge), James MacFarlane(University of Cambridge), Giulia Argentesi(St Bartholomew's Hospital), Kate Laycock(St Bartholomew's Hospital), Waiel Bashari(University of Cambridge), Claudia Cabrera(Queen Mary University of London), Samuel O’Toole(St Bartholomew's Hospital), Jackie Salsbury(Queen Mary University of London), Daniela Benu(Queen Mary University of London), Yun-Ni Lee(St Bartholomew's Hospital), Aldons Chua(St Bartholomew's Hospital), Matthew Matson(St Bartholomew's Hospital), Brendan Koo(Cambridge University Hospitals NHS Foundation Trust), Laila Parvanta(St Bartholomew's Hospital), Nicholas Hilliard(Cambridge University Hospitals NHS Foundation Trust), Vasilis Kosmoliaptsis(Cambridge University Hospitals NHS Foundation Trust), Alison Marker(Cambridge University Hospitals NHS Foundation Trust), Daniel M. Berney(Barts Health NHS Trust), K Drew(Queen Mary University of London), Wilson Lek Wen Tan(National University of Singapore), Roger Foo(National University of Singapore), Charles A. Mein(Queen Mary University of London), Eva Wozniak(Queen Mary University of London), Jessica Kearney(St Bartholomew's Hospital), Emanuel Savage(Queen Mary University of London), Anju Sahdev(St Bartholomew's Hospital), Nicholas J. Bird(Cambridge University Hospitals NHS Foundation Trust), Graham A. Smith(University of Cambridge), Matthew Hird(University of Cambridge), Victoria Warnes(Cambridge University Hospitals NHS Foundation Trust), Daniel Gillett(Cambridge University Hospitals NHS Foundation Trust), Anne Dawnay(St Bartholomew's Hospital), Elizabeth Adeyeye(Guy's and St Thomas' NHS Foundation Trust), Franklin I. Aigbirhio(University of Cambridge), Alasdair McIntosh(University of Glasgow), Alex McConnachie(University of Glasgow), J. CRUICKSHANK(King's College London), Heok Cheow(Cambridge University Hospitals NHS Foundation Trust), Mark Gurnell(University of Cambridge), William M Drake(St Bartholomew's Hospital), Morris J. Brown(St Bartholomew's Hospital)
Annals of Internal Medicine
March 1, 2025
10.7326/annals-24-00761
Cited by 23

Abstract

BACKGROUND: Primary aldosteronism (PA) causes hypertension and is potentially surgically curable when it is caused by a unilateral aldosterone-producing adrenal adenoma (APA). Adrenal vein sampling (AVS) is required to guide surgery, but it is invasive, is technically difficult, and has limited availability. OBJECTIVE: F]CETO). DESIGN: Prospective within-patient comparison of diagnostic interventions. (ClinicalTrials.gov: NCT02945904). SETTING: Three referral centers. PARTICIPANTS: 174 patients with PA desiring surgery if a unilateral source of PA was diagnosed. INTERVENTION: F]CETO in the final 31. MEASUREMENTS: F]CETO. RESULTS: C]MTO agreed in 29 of 31 patients (κ = 0.85 [CI, 0.68 to 1.00]). LIMITATION: C]MTO could be assessed only in the surgical group. CONCLUSION: Molecular imaging is an accurate, noninvasive alternative to AVS. PRIMARY FUNDING SOURCE: National Institute for Health and Care Research.

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