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Background <p>Primary aldosteronism (PA) accompanied by subclinical Cushing’s syndrome (SCS) complicates both diagnosis and clinical management. This study aimed to investigate the endocrine and metabolic profiles as well as the ⁶⁸Ga‑pentixafor PET/CT imaging features of PA‑SCS, and to evaluate its diagnostic performance for PA‑SCS.</p> Results <p>A total of 52 patients with primary aldosteronism who underwent <sup>68</sup>Ga-pentixafor PET/CT were retrospectively enrolled, including 25 patients with PA complicated by subclinical Cushing’s syndrome (PA-SCS) and 27 patients with isolated PA. Adrenal lesions in PA-SCS patients were significantly larger than those in patients with isolated PA (1.10 ± 0.56&#xa0;cm vs. 2.24 ± 0.69&#xa0;cm, <i>P</i> &lt; 0.0001). The lesion-to-contralateral ratio (LCR) at both early and delayed phases was significantly higher in the PA-SCS group (10&#xa0;min: 1.41 [1.02, 2.65] vs. 2.90 [2.01, 3.77], <i>P</i> = 0.003; 40&#xa0;min: 1.26 [1.03, 3.53] vs. 3.00 [1.80, 4.07], <i>P</i> = 0.012). The LCR-10&#xa0;min achieved the optimal diagnostic performance for differentiating PA-SCS from isolated PA (AUC = 0.737, cutoff = 1.935, sensitivity = 80.00%, specificity = 66.67%).</p> Conclusions <p>⁶⁸Ga‑pentixafor PET/CT is an effective imaging modality for differentiating PA‑SCS from isolated PA, which complements conventional diagnostic. Methods and optimizes early diagnosis and clinical management of PA‑SCS patients.</p>

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68Ga-pentixafor PET/CT imaging characteristics in primary aldosteronism with coexisting subclinical cushing syndrome: a retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月7日

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  • Shuang Liu,
  • Rui Zuo,
  • Mengdan Li,
  • Jing Chen,
  • Jia Li,
  • Xiaoyang Zhang,
  • Qifu Li,
  • Hua Pang,
  • Lu Xu

摘要

Background

Primary aldosteronism (PA) accompanied by subclinical Cushing’s syndrome (SCS) complicates both diagnosis and clinical management. This study aimed to investigate the endocrine and metabolic profiles as well as the ⁶⁸Ga‑pentixafor PET/CT imaging features of PA‑SCS, and to evaluate its diagnostic performance for PA‑SCS.

Results

A total of 52 patients with primary aldosteronism who underwent 68Ga-pentixafor PET/CT were retrospectively enrolled, including 25 patients with PA complicated by subclinical Cushing’s syndrome (PA-SCS) and 27 patients with isolated PA. Adrenal lesions in PA-SCS patients were significantly larger than those in patients with isolated PA (1.10 ± 0.56 cm vs. 2.24 ± 0.69 cm, P < 0.0001). The lesion-to-contralateral ratio (LCR) at both early and delayed phases was significantly higher in the PA-SCS group (10 min: 1.41 [1.02, 2.65] vs. 2.90 [2.01, 3.77], P = 0.003; 40 min: 1.26 [1.03, 3.53] vs. 3.00 [1.80, 4.07], P = 0.012). The LCR-10 min achieved the optimal diagnostic performance for differentiating PA-SCS from isolated PA (AUC = 0.737, cutoff = 1.935, sensitivity = 80.00%, specificity = 66.67%).

Conclusions

⁶⁸Ga‑pentixafor PET/CT is an effective imaging modality for differentiating PA‑SCS from isolated PA, which complements conventional diagnostic. Methods and optimizes early diagnosis and clinical management of PA‑SCS patients.