11C-metomidate positron emission tomography after dexamethasone suppression for detection of small adrenocortical adenomas in primary aldosteronism
Abstract
Purpose To evaluate whether dexamethasone suppression treatment can improve (11) C-metomidate positron emission tomography (MTO-PET) detection of small adrenocortical adenomas in primary aldosteronism (PA).Materials and methods Eleven patients with proven PA and two patients with non-hyperfunctioning adrenocortical incidentalomas and small adrenocortical tumours observed on CT underwent MTO-PET before and 3 days after administration of oral dexamethasone suppression treatment. Small "hot-spot" regions of interest comprising 4 pixels (SUVhs) and 1 pixel (SUVmax) were placed in the tumour area with the highest radioactivity concentration and their respective standardised uptake values (SUV) were recorded.Results All tumours were detected and categorised as adrenocortical by MTO-PET. SUVhs as well as SUVmax were higher in PA compared to nonfunctional adenomas. Normal adrenal cortex was suppressed after dexamethasone (p < 0.05), but tumour SUV was not significantly decreased after suppression in either PA or nonfunctional tumours (p > 0.05). However, these changes caused no significant increase in the tumour-to-normal adrenal ratio (p > 0.05).Conclusion MTO-PET is a highly sensitive method for detecting and categorising even small adrenocortical tumours in PA. In this series, dexamethasone-suppressed MTO-PET was unable to increase the tumour-to-normal adrenal ratio to further facilitate detection of small adenomas in PA as an alternative to adrenal venous sampling.
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Carbon-11 metomidate PET-CT is a sensitive and specific technique for diagnosing adrenocortical tumors.
“Carbon-11 (11C) metomidate (MTO) PET-CT is a sensitive and specific technique for diagnosing adrenocortical tumors (363) and has high accuracy for lateralizing aldosterone secretion by Conn’s adenomas (364,365).”
From Adrenal incidentaloma (2020) · cites this paper as [363]
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“Carbon-11 ( 11 C) metomidate (MTO) PET-CT is a sensitive and specific technique for diagnosing adrenocortical tumors (363) and has high accuracy for lateralizing aldosterone secretion by Conn’s adenomas (364,365).”
BackgroundBurton, T. J., Mackenzie, I. S., Balan, K., Koo, B., Bird, N., Soloviev, D. V., Azizan, E. A. B., Aigbirhio, F., Gurnell, M., & Brown, M. J. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-1537 · Cited by 226 · see citing works
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Self-citation
- Authors
- Hennings, J., Sundin, A., Hägg, A., & Hellman, P.
- Affiliations
- Uppsala University (SE)
- Corresponding author
- Hennings, J.
- Venue
- Langenbeck s Archives of Surgery
- Published
- 2010-07-20
- Volume
- 395
- Issue
- 7
- Pages
- 963-967
- ISSN
- 0023-8236 (ISSN-L)
- 1435-2443
- 1435-2451
- OpenAlex
- W2025016241
- Cited by
- 44
- References
- 24
- Citations by year
- 2025: 3 · 2023: 3 · 2022: 2 · 2021: 1 · 2020: 7 · 2019: 3 · 2018: 2 · 2017: 4 · 2016: 5 · 2015: 2 · 2014: 1 · 2013: 2 · 2012: 3
- FWCI
- 2.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Langenbeck s Archives of Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Keywords
- dexamethasone suppression, primary aldosteronism, adrenal adenoma, standardized uptake value
- MeSH terms
- Administration, Oral, Adult, Aged, Biopsy, Needle, Dexamethasone, Dose-Response Relationship, Drug, Drug Administration Schedule, Etomidate, Female, Follow-Up Studies, Humans, Hyperaldosteronism, Immunohistochemistry, Male, Middle Aged, Neoplasm Staging, Sampling Studies, Treatment Outcome, Adrenocortical Adenoma, Tumor Burden, Positron-Emission Tomography
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