Abstract
OE1
DIAGNOSTIC VALUE OF ADRENAL I-131 NP-59 SCINTIGRAPHY FOR PRIMARY ALDOSTERONISM: A RETROSPECTIVE STUDY AT A MEDICAL CENTER IN NORTH TAIWAN 1
WU MING-HSIEN, 1 LIU FENG-HSUAN, 2 LIN KUN-JU, 1 SUN JUI-HUNG, 1 CHEN SZU-TAH 1
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan.; 2Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital, Chang Gung University, Kweishan, Taoyuan, Taiwan
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 I-131 1,6-beta-iodomethyl-19-norcholesterol (NP-59) adrenal scintigraphy to distinguish PA from APA. Methods: Patients clinically suspected of PA from March 2000 to October 2016 were retrospectively analyzed. A total of 145 patients, including 74 post-unilateral adrenalectomy and 7 post-radiofrequency ablation for adrenal mass, were reviewed. All patients received NP-59 adrenal VFLQWLJUDSK\ SULRU WR VXUJHU\ 7KH DFFXUDF\ RI WKH 13 DGUHQDO VFLQWLJUDSK\ ZDV FRQ¿UPHG E\ WKH SDWKRORJLF ¿QGLQJV DQG SRVWRSHUDWLYH RXWFRPHV 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 7 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, SPECT/CT scan increased WKH VHQVLWLYLW\ DQG VSHFL¿FLW\ EXW QRW WKH SRVLWLYH SUHGLFWLYH YDOXH DQG RI 13 59 scintigraphy in this study. Conclusions: 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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