Scintigraphic assessment of therapeutic success in aldosteronomas treated by transcatheter arterial embolization using absolute ethanol.
Adrenocortical scintigraphy was examined as an indicator of therapeutic success in aldosteronomas treated by transcatheter arterial embolization (TAE) with absolute ethanol (AE).


METHODS
Adrenocortical scintigraphy was performed 7 days after intravenous injection of 37 MBq 131I-6-beta-iodomethyl-19-norcholesterol before and after TAE. Complete or incomplete therapeutic success was determined by periodic measurements of the levels of plasma aldosterone and correlated with the scintigraphic results.


RESULTS
The aldosteronoma was visualized as a hot nodule in nine patients and a warm nodule in one patient before TAE. Scintigraphy showed a hot, residual hot or warm nodule on seven occasions (six occasions after the first TAE and one occasion after the second TAE) when the techniques were incompletely successful and disappearance on seven occasions when success was achieved (three occasions after the first TAE and one occasion after the second TAE). Of the seven occasions when TAE was unsuccessful, four patients received the second or third TAE to result in complete destruction of the aldosteronoma; three patients underwent unilateral adrenalectomy.


CONCLUSIONS
Adrenocortical scintigraphy can correctly predict the effect of TAE on aldosteronomas and is a valuable indicator for decisions on the necessity of repeated TAE or adrenalectomy.
Nakajo
M
M
Department of Radiology, Faculty of Medicine, Kagoshima University, Japan.
Nakabeppu
Y
Y
Tsuchimochi
S
S
Miyazono
N
N
Inoue
H
H
Ueno
K
K
Nishida
H
H
D000301:Adosterol; D000306:Adrenal Cortex Neoplasms / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D018246:Adrenocortical Adenoma / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D000328:Adult; D000450:Aldosterone / Q000097:blood; D016461:Chemoembolization, Therapeutic; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging
D007457:Iodine Radioisotopes; D000431:Ethanol; D000450:Aldosterone; D000301:Adosterol