Molecular Imaging Versus Adrenal Vein Sampling for the Detection of Surgically Curable Primary Aldosteronism

BACKGROUND: Primary aldosteronism (PA) causes hypertension and is potentially surgically curable when it is caused by a unilateral aldosterone-producing adrenal adenoma (APA). Adrenal vein sampling (AVS) is required to guide surgery, but it is invasive, is technically difficult, and has limited availability. OBJECTIVE: F]CETO). DESIGN: Prospective within-patient comparison of diagnostic interventions. (ClinicalTrials.gov: NCT02945904). SETTING: Three referral centers. PARTICIPANTS: 174 patients with PA desiring surgery if a unilateral source of PA was diagnosed. INTERVENTION: F]CETO in the final 31. MEASUREMENTS: F]CETO. RESULTS: C]MTO agreed in 29 of 31 patients (κ = 0.85 [CI, 0.68 to 1.00]). LIMITATION: C]MTO could be assessed only in the surgical group. CONCLUSION: Molecular imaging is an accurate, noninvasive alternative to AVS. PRIMARY FUNDING SOURCE: National Institute for Health and Care Research.