NP-59 Adrenal Scintigraphy as an Imaging Biomarker to Predict KCNJ5 Mutation in Primary Aldosteronism Patients

Lu, Ching‐Chu; Yen, Ruoh‐Fang; Peng, Kang-Yung; Huang, Jian-Jia; Wu, Kwan‐Dun; Chueh, Shih-Chieh; Lin, Wan-Yu

doi:10.3389/fendo.2021.644927

Cited by 5 publications

(4 citation statements)

References 44 publications

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“…A recent examination of 131 I-NP-59 uptake in primary adrenal aldosteronism from adenoma by Lu et al, describe the adrenal-to-liver ratio of 131 I-NP-59 as 2-2.8 following dexamethasone suppression depending on the genetic profile. 43 Similarly, there was a 40 to 75% increased uptake of 131 I-NP-59 in the pathologic adrenal gland versus the normal gland. Consequently, using Lu at al.…”

Section: Discussionmentioning

confidence: 93%

Development of Fluorinated NP-59: A Revival of Cholesterol Use Imaging with PET

et al. 2022

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Section: Discussionmentioning

confidence: 93%

Development of Fluorinated NP-59: A Revival of Cholesterol Use Imaging with PET

et al. 2022

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“…The former showed significantly higher tracer uptake (HSUV max , 22.2 vs 10.8; LSUV max , 19.4 vs 9.5; Figure 3) than the latter. We previously reported that patients harboring KCNJ5 mutations had higher NP-59 uptake than wild-type patients 38 . KCNJ5 mutation plays an important role in the pathophysiology of PA and can lead to the persistent overproduction of aldosterone by altered selectivity of encoded potassium channel 39 .…”

Section: Discussionmentioning

confidence: 99%

“…We previously reported that patients harboring KCNJ5 mutations had higher NP-59 uptake than wild-type patients. 38 KCNJ5 mutation plays an important role in the pathophysiology of PA and can lead to the persistent overproduction of aldosterone by altered selectivity of encoded potassium channel. 39 The mechanism of higher MTO uptake in patients with KCNJ5 mutation is probably because of the overexpression of CYP11B2.…”

mentioning

confidence: 99%

Predicting Treatment Response in Primary Aldosteronism Using 11C-Metomidate Positron Emission Tomography

Lu¹,

Chen²,

Peng³

et al. 2022

Clin Nucl Med

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Background: Appropriate treatment of primary aldosteronism (PA) depends on accurate lateralization. 11 C-metomidate (MTO) is a tracer used in PET that provides functional information about the adrenal cortex. We aimed to perform MTO PET for patients with PA who are managed according to the guideline and to verify its correlation with other lateralization modalities and usefulness in outcome prediction. Methods: Seventeen patients with PA who underwent MTO PET and had ≥1 lateralization modality (adrenal venous sampling and/or NP-59 adrenal scintigraphy) were included. SUV max of each adrenal gland (higher uptake side, HSUV max ; lower uptake side, LSUV max ) and the ratio of HSUV max to LSUV max (contrast) were compared with lateralization modalities, postsurgical outcomes, and medical treatment outcomes. Cutoff values were used as outcome predictors. Results: HSUV max and LSUV max increased in the order of bilateral, unilateral, and negative findings of CT, with opposite order of contrast. High discordant rate between MTO PET and other lateralization modalities was noted. Biochemical responders (n = 8) had significantly lower HSUV max and LSUV max than nonresponders, and clinical responders (n = 6) had borderline lower HSUV max than nonresponders. By optimal cutoff values of HSUV max and LSUV max , MTO PET was able to predict biochemical and clinical outcomes in patients with medical treatment. Conclusion: According to adrenal CT findings, MTO PET presented different uptake patterns. Patients with PA under medical treatment showed significantly lower tracer uptake in responders. Thus, MTO PET may be a useful imaging biomarker to predict medical treatment outcome. Multicenter prospective study with a larger number of patients is needed for further validation.

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“…NP-59 adrenal scintigraphy is a functional study used to evaluate adrenal cortical activity. Lu et al reported using semiquantitative NP-59 adrenal scintigraphy as an imaging biomarker to predict KCNJ5 mutations in PA patients (133). Among 62 PA patients who underwent NP-59 adrenal scintigraphy with available KCNJ5 mutation status, adrenal-to-liver ratio (ALR) and maximal count ratio between two adrenal glands (contrast, CON) derived from NP-59 adrenal scintigraphy were used to differentiate patients with and without KCNJ5 mutations.…”

Section: Np-59 To Predict Kcnj5 Mutationsmentioning

confidence: 99%

Cardiovascular and metabolic characters of KCNJ5 somatic mutations in primary aldosteronism

Chang

Lee²,

Chen³

et al. 2023

Front. Endocrinol.

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BackgroundPrimary aldosteronism (PA) is the leading cause of curable endocrine hypertension, which is associated with a higher risk of cardiovascular and metabolic insults compared to essential hypertension. Aldosterone-producing adenoma (APA) is a major cause of PA, which can be treated with adrenalectomy. Somatic mutations are the main pathogenesis of aldosterone overproduction in APA, of which KCNJ5 somatic mutations are most common, especially in Asian countries. This article aimed to review the literature on the impacts of KCNJ5 somatic mutations on systemic organ damage.Evidence acquisitionPubMed literature research using keywords combination, including “aldosterone-producing adenoma,” “somatic mutations,” “KCNJ5,” “organ damage,” “cardiovascular,” “diastolic function,” “metabolic syndrome,” “autonomous cortisol secretion,” etc.ResultsAPA patients with KCNJ5 somatic mutations are generally younger, female, have higher aldosterone levels, lower potassium levels, larger tumor size, and higher hypertension cure rate after adrenalectomy. This review focuses on the cardiovascular and metabolic aspects of KCNJ5 somatic mutations in APA patients, including left ventricular remodeling and diastolic function, abdominal aortic thickness and calcification, arterial stiffness, metabolic syndrome, abdominal adipose tissue, and correlation with autonomous cortisol secretion. Furthermore, we discuss modalities to differentiate the types of mutations before surgery.ConclusionKCNJ5 somatic mutations in patients with APA had higher left ventricular mass (LVM), more impaired diastolic function, thicker aortic wall, lower incidence of metabolic syndrome, and possibly a lower incidence of concurrent autonomous cortisol secretion, but better improvement in LVM, diastolic function, arterial stiffness, and aortic wall thickness after adrenalectomy compared to patients without KCNJ5 mutations.

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NP-59 Adrenal Scintigraphy as an Imaging Biomarker to Predict KCNJ5 Mutation in Primary Aldosteronism Patients

Cited by 5 publications

References 44 publications

Development of Fluorinated NP-59: A Revival of Cholesterol Use Imaging with PET

Development of Fluorinated NP-59: A Revival of Cholesterol Use Imaging with PET

Predicting Treatment Response in Primary Aldosteronism Using 11C-Metomidate Positron Emission Tomography

Cardiovascular and metabolic characters of KCNJ5 somatic mutations in primary aldosteronism

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