title: Diagnostic value of I-131 NP-59 SPECT/CT scintigraphy in patients with subclinical or atypical features of primary aldosteronism.
abstract: Accumulating evidence has shown the adverse effect of long-term hyperaldosteronism on cardiovascular morbidity that is independent of blood pressure. However, the diagnosis of primary aldosteronism (PA) remains a challenge for patients who present with subtle or atypical features or have chronic kidney disease (CKD). SPECT/CT has proven valuable in the diagnosis of a number of conditions. The aim of this study was to determine the usefulness of I-131 NP-59 SPECT/CT in patients with atypical presentations of PA and in those with CKD. The records of 15 patients with PA were retrospectively analyzed. NP-59 SPECT/CT was able to identify adrenal lesion(s) in CKD patients with suspected PA. Patients using NP-59 SPECT/CT imaging, compared with those not performing this procedure, significantly featured nearly normal serum potassium levels, normal aldosterone-renin ratio, and smaller adrenal size on CT and pathological examination and tended to feature stage 1 hypertension and non-suppressed plasma renin activity. These findings show that noninvasive NP-59 SPECT/CT is a useful tool for diagnosis in patients with subclinical or atypical features of PA and those with CKD.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, and School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Chen
authors.forename: Yu-Chieh
authors.initials: YC
authors.lastname: Su
authors.forename: Chang-Kuo
authors.initials: CK
authors.lastname: Wei
authors.forename: Jainn-Shiun
authors.initials: JS
authors.lastname: Chiu
authors.forename: Chih-En
authors.initials: CE
authors.lastname: Tseng
authors.forename: Shao-Jer
authors.initials: SJ
authors.lastname: Chen
authors.forename: Yuh-Feng
authors.initials: YF
authors.lastname: Wang
mesh_terms: D000301:Adosterol; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003710:Demography; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000000981:diagnostic imaging* / Q000473:pathology; D007457:Iodine Radioisotopes; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes; D000301:Adosterol