Molecular Imaging Versus Adrenal Vein Sampling for the Detection of Surgically Curable Primary Aldosteronism
Emily Goodchild, Xilin Wu, Russell Senanayake, James MacFarlane, Giulia Argentesi, Kate Laycock, Waiel Bashari, Claudia Cabrera, Samuel O’Toole, Jackie Salsbury, Daniela Benu, Yun-Ni Lee, Aldons Chua, Matthew Matson, Brendan Koo, Laila Parvanta, Nicholas Hilliard, Vasilis Kosmoliaptsis, Alison Marker, Daniel M. Berney, K Drew, Wilson Lek Wen Tan, Roger Foo, Charles A. Mein, Eva Wozniak, Jessica Kearney, Emanuel Savage, Anju Sahdev, Nicholas J. Bird, Graham A. Smith, Matthew Hird, Victoria Warnes, Daniel Gillett, Anne Dawnay, Elizabeth Adeyeye, Franklin I. Aigbirhio, Alasdair McIntosh, Alex McConnachie, J. CRUICKSHANK, Heok Cheow, Mark Gurnell, William M Drake, Morris J. Brown
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.