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Cited by 20Hormonal Regulation and HypertensionAdrenal and Paraganglionic TumorsAdrenal Hormones and Disorders

Diagnostic value of adrenal iodine-131 6-beta-iodomethyl-19-norcholesterol scintigraphy for primary aldosteronism: a retrospective study at a medical center in North Taiwan

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Wu, Ming-Hsien, Liu, Feng-Hsuan, Lin, Kun-Ju, Sun, Jui-Hung, Chen, Szu-Tah·2019·Nuclear Medicine Communications
DOI 10.1097/mnm.0000000000000987PMC PMC6553523
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Abstract

BACKGROUND: Primary aldosteronism (PA) is a common cause of secondary hypertension. Among the many leading causes of PA, the two most frequent are, bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenomas (APA). Since a solitary APA may be cured surgically, but BAH needs lifelong pharmacologic therapy, confirmation is mandatory before surgery. We herein sought to determine the diagnostic value of iodine-131 6-beta-iodomethyl-19-norcholesterol (NP-59) adrenal scintigraphy to distinguish BAH from APA. PATIENTS AND METHODS: Patients clinically suspected of PA from March 2000 to October 2016 were retrospectively analyzed. A total of 145 patients, including 74 postunilateral adrenalectomy and seven postradiofrequency ablation for adrenal mass, were reviewed. All patients received NP-59 adrenal scintigraphy prior to surgery. The accuracy of the NP-59 adrenal scintigraphy was confirmed by the pathologic findings and postoperative outcomes. RESULTS: Among 81 patients receiving interventional procedures for adrenal mass, adenoma was eventually diagnosed in 72 patients according to their pathologic results, with 60 unilaterally and seven bilaterally localized lesions by NP-59 scintigraphy; nevertheless, there were five negative findings initially. The sensitivity, specificity, and positive predictive value of NP-59 scintigraphy for APA detection were therefore 83.3, 44.4, and 92.3%, respectively. Moreover, single-photon emission computed tomography/computed tomography scan increased the sensitivity and specificity, but not the positive predictive value (85.0, 60.0, and 89.5%) of NP-59 scintigraphy in this study. CONCLUSION: NP-59 adrenal scintigraphy is a useful imaging test to detect APA. Lateralization by this modality prior to surgical intervention may reduce the need for such invasive procedures as adrenal venous sampling.

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  • NP-59 scintigraphy has a positive predictive value of 92% for differentiation of aldosterone-producing adenoma from bilateral adrenal hyperplasia in primary aldosteronism.

    “Recent data have reported a positive predictive value of 92% for differentiation of aldosterone-producing adenoma from bilateral adrenal hyperplasia in primary aldosteronism, potentially reducing the need for invasive adrenal venous sampling (359).”

    From Adrenal incidentaloma (2020) · cites this paper as [359]

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  • Adrenal incidentaloma

    Sherlock, M., Scarsbrook, A., Abbas, A., Fraser, S., Limumpornpetch, P., Dineen, R., & Stewart, P. M. (2020) · Endocrine Reviews · doi:10.1210/endrev/bnaa008 · Cited by 347 · see citing works

    “Recent data have reported a positive predictive value of 92% for differentiation of aldosterone-producing adenoma from bilateral adrenal hyperplasia in primary aldo-steronism, potentially reducing the need for invasive adrenal venous sampling (359).”
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Related

Authors
Wu, M.-H., Liu, F.-H., Lin, K.-J., Sun, J.-H., & Chen, S.-T.
Affiliations
  • Chang Gung University (TW)
  • Chang Gung Memorial Hospital (TW)
Corresponding author
Chen, Szu-Tah
ORCID
Venue
Nuclear Medicine Communications
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2019-06
Volume
40
Issue
6
Pages
568-575
ISSN
0143-3636 (ISSN-L)
DOI
10.1097/mnm.0000000000000987
PMC
PMC6553523
OpenAlex
W2913050361
Cited by
20
References
34
Citations by year
2025: 1 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 4 · 2020: 4
FWCI
2.64
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Nuclear Medicine Communications (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
  • Chang Gung Memorial Hospital (CMRPG3D1813)
  • Chang Gung Medical Foundation
  • National Taiwan University Hospital
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
primary aldosteronism, aldosterone-producing adenoma, bilateral adrenal hyperplasia, adrenal mass, preoperative diagnosis, adrenal vein sampling, SPECT/CT, diagnostic accuracy, secondary hypertension
MeSH terms
Academic Medical Centers, Adrenal Glands, Adult, Aged, Female, Humans, Hyperaldosteronism, Male, Middle Aged, Radionuclide Imaging, Retrospective Studies, Taiwan, 19-Iodocholesterol

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