TY - JOUR
T1 - 11C-metomidate PET in the diagnosis of adrenal masses and primary aldosteronism
T2 - a review of the literature
AU - Chen Cardenas, Stanley M.
AU - Santhanam, Prasanna
N1 - Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/12
Y1 - 2020/12
N2 - Background: Adrenal masses are commonly encountered in clinical practice, many of whom are incidental. Identifying malignancy, and excess hormone production is essential for appropriate management. Biochemical workup and imaging tests (dedicated adrenal CT and/or MRI) are used to determine the likelihood of excessive hormone function and malignancy, respectively. However, imaging cannot provide information about function and biochemical workup cannot localize the source. Furthermore, in primary aldosteronism, adrenal vein sampling, the gold standard for lateralization, has important limitations such as the technical expertise required, the elevated costs, and potential complications. Over the last decades, there has been a renewed interest in alternative noninvasive imaging techniques that provide information about adrenal function without the need for invasive procedures. In this review, we will evaluate the evidence and the potential role of 11C-metomidate as a promising positron emission tomography (PET) tracer in clinical practice. Methods: A review of the English literature for articles describing the use of the tracer 11C-metomidate in adrenal disorders. Results: A total of 12 studies were included in the systematic review, which altogether addressed the use of 11C-metomidate in adrenal masses and the application of this tracer in primary aldosteronism. Conclusions: 11C-metomidate, a selective inhibitor of 11-β-hydroxylase, demonstrated a high specificity for adrenocortical tissue. In addition, 11C-metomidate is correlated with this enzyme activity making it a potentially useful PET tracer for the identification primary aldosteronism, in addition to detection of adrenocortical masses.
AB - Background: Adrenal masses are commonly encountered in clinical practice, many of whom are incidental. Identifying malignancy, and excess hormone production is essential for appropriate management. Biochemical workup and imaging tests (dedicated adrenal CT and/or MRI) are used to determine the likelihood of excessive hormone function and malignancy, respectively. However, imaging cannot provide information about function and biochemical workup cannot localize the source. Furthermore, in primary aldosteronism, adrenal vein sampling, the gold standard for lateralization, has important limitations such as the technical expertise required, the elevated costs, and potential complications. Over the last decades, there has been a renewed interest in alternative noninvasive imaging techniques that provide information about adrenal function without the need for invasive procedures. In this review, we will evaluate the evidence and the potential role of 11C-metomidate as a promising positron emission tomography (PET) tracer in clinical practice. Methods: A review of the English literature for articles describing the use of the tracer 11C-metomidate in adrenal disorders. Results: A total of 12 studies were included in the systematic review, which altogether addressed the use of 11C-metomidate in adrenal masses and the application of this tracer in primary aldosteronism. Conclusions: 11C-metomidate, a selective inhibitor of 11-β-hydroxylase, demonstrated a high specificity for adrenocortical tissue. In addition, 11C-metomidate is correlated with this enzyme activity making it a potentially useful PET tracer for the identification primary aldosteronism, in addition to detection of adrenocortical masses.
KW - Adrenal masses
KW - Adrenal tracer
KW - C-metomidate
KW - Positron emission tomography
KW - Primary aldosteronism
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U2 - 10.1007/s12020-020-02474-3
DO - 10.1007/s12020-020-02474-3
M3 - Review article
C2 - 32886316
AN - SCOPUS:85090146357
SN - 1355-008X
VL - 70
SP - 479
EP - 487
JO - Endocrine
JF - Endocrine
IS - 3
ER -