Use of NP-59 (131I-iodocholesterol) Scan as a Potential Alternative to Adrenal Venous Sampling in the Investigation of Primary Aldosteronism: a 5-Year Retrospective Study

Chan, H W; Cheng, Lei

doi:10.12809/hkjr1414230

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…However, bilateral asymmetrical uptake of NP-59 suggested contralateral suppression of normal adrenal gland or hyperfunctioning adenoma in BAH. 30 In case 5, initial NP-59 scintigraphy showed symmetric uptake in the bilateral adrenal gland. Sequential adrenalectomy was performed based on NP-scintigraphy with SPECT/CT.…”

Section: Discussionmentioning

confidence: 94%

Feasibility of Iodine-131 6β-Methyl-Iodo-19 Norcholesterol (NP-59) Scintigraphy to Complement Adrenal Venous Sampling in Management of Primary Aldosteronism: A Case Series

Lee¹,

Ha²,

Lee³

et al. 2021

IJGM

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Section: Discussionmentioning

confidence: 94%

Feasibility of Iodine-131 6β-Methyl-Iodo-19 Norcholesterol (NP-59) Scintigraphy to Complement Adrenal Venous Sampling in Management of Primary Aldosteronism: A Case Series

Lee¹,

Ha²,

Lee³

et al. 2021

IJGM

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“…This technique allows the assessment of adrenal function and can be used to differentiate between APA and IAH (unilateral adrenal uptake most likely indicates APA, and bilateral uptake suggests IAH). The administration of dexamethasone, which suppresses adrenal cortical hormones, markedly improves the diagnostic accuracy of adrenal scintigraphy [ 10 ]. In addition, in our environment, scintigraphy can reduce waiting times compared to AVS.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Adrenalectomy in a Patient With Refractory Primary Aldosteronism Due to Adrenal Hyperplasia

Marín-Martínez¹,

Ríos-Vergara²,

Kyriakos³

et al. 2022

Cureus

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Primary aldosteronism (PA) is a frequent cause of secondary hypertension. The main cause of PA is bilateral adrenal hyperplasia, and treatment is usually medical with mineralocorticoid receptor antagonists (MRAs) such as spironolactone or eplerenone. In this paper, we present a rare clinical case of a middle-aged female with refractory arterial hypertension and hypokalemia that complementary medical tests confirmed PA due to bilateral hyperplasia, and despite a maximum dose of spironolactone and oral potassium supplements, there was no clinical response. Because of this, finally, the patient needed surgical treatment based on bilateral adrenalectomy, which was effective. This is unusual and poorly described in the medical literature.

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“…Typically, bilateral symmetrical adrenal uptake of radioactive tracer suggests BAH according to the interpretation of NP-59 results 26,27. In certain conditions, bilateral asymmetric uptake of NP-59 provides limited ability to distinguish adenoma from partially suppressed normal contralateral adrenal gland or asymmetrically expanded adrenal glands in bilateral hyperplasia 27.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of adrenal iodine-131 6-beta-iodomethyl-19-norcholesterol scintigraphy for primary aldosteronism

Wu¹,

Liu²,

Lin

et al. 2019

Nuclear Medicine Communications

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Background Primary aldosteronism (PA) is a common cause of secondary hypertension. Among the many leading causes of PA, the two most frequent are, bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenomas (APA). Since a solitary APA may be cured surgically, but BAH needs lifelong pharmacologic therapy, confirmation is mandatory before surgery. We herein sought to determine the diagnostic value of iodine-131 6-beta-iodomethyl-19-norcholesterol (NP-59) adrenal scintigraphy to distinguish BAH from APA. Patients and methods Patients clinically suspected of PA from March 2000 to October 2016 were retrospectively analyzed. A total of 145 patients, including 74 postunilateral adrenalectomy and seven postradiofrequency ablation for adrenal mass, were reviewed. All patients received NP-59 adrenal scintigraphy prior to surgery. The accuracy of the NP-59 adrenal scintigraphy was confirmed by the pathologic findings and postoperative outcomes. Results Among 81 patients receiving interventional procedures for adrenal mass, adenoma was eventually diagnosed in 72 patients according to their pathologic results, with 60 unilaterally and seven bilaterally localized lesions by NP-59 scintigraphy; nevertheless, there were five negative findings initially. The sensitivity, specificity, and positive predictive value of NP-59 scintigraphy for APA detection were therefore 83.3, 44.4, and 92.3%, respectively. Moreover, single-photon emission computed tomography/computed tomography scan increased the sensitivity and specificity, but not the positive predictive value (85.0, 60.0, and 89.5%) of NP-59 scintigraphy in this study. Conclusion NP-59 adrenal scintigraphy is a useful imaging test to detect APA. Lateralization by this modality prior to surgical intervention may reduce the need for such invasive procedures as adrenal venous sampling.

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Use of NP-59 (131I-iodocholesterol) Scan as a Potential Alternative to Adrenal Venous Sampling in the Investigation of Primary Aldosteronism: a 5-Year Retrospective Study

Cited by 4 publications

References 21 publications

Feasibility of Iodine-131 6β-Methyl-Iodo-19 Norcholesterol (NP-59) Scintigraphy to Complement Adrenal Venous Sampling in Management of Primary Aldosteronism: A Case Series

Feasibility of Iodine-131 6β-Methyl-Iodo-19 Norcholesterol (NP-59) Scintigraphy to Complement Adrenal Venous Sampling in Management of Primary Aldosteronism: A Case Series

Bilateral Adrenalectomy in a Patient With Refractory Primary Aldosteronism Due to Adrenal Hyperplasia

Diagnostic value of adrenal iodine-131 6-beta-iodomethyl-19-norcholesterol scintigraphy for primary aldosteronism

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