11C‐Metomidate PET/CT is a useful adjunct for lateralization of primary aldosteronism in routine clinical practice
Open accessAbstract
Summary Objective To describe clinical practice experience of 11C‐Metomidate PET/CT as an adjunct to adrenal vein sampling (AVS) in the lateralization of aldosterone‐producing adenomas (APA) in primary aldosteronism (PA). Context Accurate lateralization of APA in the setting of PA offers the potential for surgical cure and improved long‐term cardiovascular outcomes. Challenges associated with AVS, the current gold standard lateralization modality, mean that only a small proportion of potentially eligible patients currently make it through to surgery. This has prompted consideration of alternative strategies for lateralization, including the application of novel molecular PET tracers such as 11C‐Metomidate. Design Clinical Service Evaluation/Retrospective audit. Patients Fifteen individuals with a confirmed diagnosis of PA, undergoing lateralization with 11C‐Metomidate PET/CT prior to final clinical decision on surgical vs medical management. Measurements All patients underwent screening aldosterone renin ratio (ARR), followed by confirmatory testing with the seated saline infusion test, according to Endocrine Society Clinical Practice Guidelines. Adrenal glands were imaged using dedicated adrenal CT. 11C‐Metomidate PET/CT was undertaken due to equivocal or failed AVS. Management outcomes were assessed by longitudinal measurement of blood pressure, ARR, number of hypertensive medications following adrenalectomy or institution of medical therapy. Results We describe the individual lateralization and clinical outcomes for 15 patients with PA. Conclusion 11C‐Metomidate PET/CT in conjunction with adrenal CT and AVS provided useful information which aided clinical decision‐making for PA within a multidisciplinary hypertension clinic.
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Carbon-11 metomidate PET-CT has high accuracy for lateralizing aldosterone secretion by Conn's adenomas.
“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 [365]
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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
“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).”
Background
- Authors
- O’Shea, P. M., O’Donoghue, D., Bashari, W., Senanayake, R., Joyce, M. B., Powlson, A. S., Browne, D., O’Sullivan, G. J., Cheow, H., Mendichovszky, I., Quill, D., Lowery, A., Lappin, D., Gurnell, M., & Dennedy, M. C.
- Affiliations
- University Hospital Galway (IE)
- Ollscoil na Gaillimhe – University of Galway (IE)
- University of Cambridge (GB)
- Addenbrooke's Hospital (GB)
- Department of Surgery Galway University Hospital Galway Ireland
- Corresponding author
- Dennedy, Michael C.
- ORCID
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2019-03-18
- Volume
- 90
- Issue
- 5
- Pages
- 670-679
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2914915730
- Cited by
- 58
- References
- 36
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 4 · 2023: 8 · 2022: 10 · 2021: 13 · 2020: 11 · 2019: 5
- FWCI
- 7.91
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Apollo (University of Cambridge) (submittedVersion)
- Apollo
- Funders
- Medical Research Council (MR/M024873/1, MR/M009041/1)
- 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, laterality, adrenal vein sampling, PET/CT, adrenalectomy, hypertension, aldosterone-renin ratio, surgical decision-making
- MeSH terms
- Clinical Decision-Making, Positron Emission Tomography Computed Tomography, Adult, Etomidate, Humans, Hyperaldosteronism, Radiopharmaceuticals
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