Clinical nuclear medicine · 2025
First-in-Human Evaluation of [ 18 F]AldoView: A Highly Selective PET Tracer for Aldosterone Synthase Imaging in Primary Aldosteronism.
СтатьяКлиническое исследованиеНазвание и аннотация: Перевод в очереди
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Long Tingting, Liu Geru, Zhou Ming, Zhang Zhen, Xiao Yao, Chen Huizhu, Peng Ning, Jin Yuzhen, He Yao, Gan Yu, Chen Zhi, Luo Min, Li Chun, Xiao Yuan, Liu Zehao, Guo Min, Xia Zhuying, Wang Min, Wang Jing, Liu Longfei, Luo Xianghang, Jiang Tiejian, Hu Shuo
Аннотация
OBJECTIVES: Aldosterone synthase (CYP11B2) is overexpressed in primary aldosteronism (PA), making it a promising target for imaging. This first-in-human study evaluates the safety and feasibility of [ 18 F]AldoView, a highly selective PET tracer targeting CYP11B2, for PA subtyping.
METHODS: Biodistribution and dosimetry of [ 18 F]AldoView were assessed in 3 healthy volunteers using whole-body PET/CT. Fifteen patients with adrenal lesions (13 with PA, 1 with Cushing's syndrome, and 1 with a nonfunctional adenoma) were enrolled. PET/CT scans were performed 60 minutes postinjection. Lesions were considered positive if tracer uptake exceeded normal adrenal tissue. Semi-quantitative analyses included maximum standardized uptake value (SUVmax), lesion-to-liver ratio (LLR), and lesion-to-adrenal ratio (LAR). Ten PA patients with positive imaging findings and 1 with Cushing's syndrome underwent adrenalectomy, and resected specimens were analyzed for CYP11B2 expression. This ongoing study is registered with the Chinese Clinical Trial Registry (ChiCTR2400093214).
RESULTS: [ 18 F]AldoView was well-tolerated, with no adverse events. The effective dose was 0.012±0.0022 mSv/MBq. PET/CT identified positive lesions in all 10 PA patients, with a mean SUVmax of 15.73±8.57, LAR of 8.02±4.06, and LLR of 10.24±1.48. No positive lesions were observed in patients with idiopathic hyperaldosteronism, Cushing's syndrome, or nonfunctional adenomas. Positive lesions showed strong CYP11B2 staining on pathology, confirming aldosterone-producing adenomas (APA) or nodules (APN).
CONCLUSIONS: [ 18 F]AldoView PET/CT is safe and feasible for the imaging of APAs and APNs in PA patients. These results highlight its potential for noninvasive in vivo detection of CYP11B2, supporting its use in PA subtyping.
METHODS: Biodistribution and dosimetry of [ 18 F]AldoView were assessed in 3 healthy volunteers using whole-body PET/CT. Fifteen patients with adrenal lesions (13 with PA, 1 with Cushing's syndrome, and 1 with a nonfunctional adenoma) were enrolled. PET/CT scans were performed 60 minutes postinjection. Lesions were considered positive if tracer uptake exceeded normal adrenal tissue. Semi-quantitative analyses included maximum standardized uptake value (SUVmax), lesion-to-liver ratio (LLR), and lesion-to-adrenal ratio (LAR). Ten PA patients with positive imaging findings and 1 with Cushing's syndrome underwent adrenalectomy, and resected specimens were analyzed for CYP11B2 expression. This ongoing study is registered with the Chinese Clinical Trial Registry (ChiCTR2400093214).
RESULTS: [ 18 F]AldoView was well-tolerated, with no adverse events. The effective dose was 0.012±0.0022 mSv/MBq. PET/CT identified positive lesions in all 10 PA patients, with a mean SUVmax of 15.73±8.57, LAR of 8.02±4.06, and LLR of 10.24±1.48. No positive lesions were observed in patients with idiopathic hyperaldosteronism, Cushing's syndrome, or nonfunctional adenomas. Positive lesions showed strong CYP11B2 staining on pathology, confirming aldosterone-producing adenomas (APA) or nodules (APN).
CONCLUSIONS: [ 18 F]AldoView PET/CT is safe and feasible for the imaging of APAs and APNs in PA patients. These results highlight its potential for noninvasive in vivo detection of CYP11B2, supporting its use in PA subtyping.