SFEBES2022 Oral Poster Presentations Adrenal and Cardiovascular (4 abstracts)
Novel radiolabeled ligand, Para-chloro-2-[18F]fluoroethyletomidate (CETO) compared to [11C]metomidate-PET (MTO) for the lateralisation of primary aldosteronism (PA)
Emily Goodchild 1,2 , Russell Senanayake 3,4 , Xilin Wu 1,2 , Waiel Bashari 3 , Jackie Salsbury 1,2 , Giulia Argentesi 1,2 , Samuel O’Toole 1,2 , James MacFarlane 3,4 , Kate Laycock 1,2 , Dan Gillett 4 , Istvan Boros 3 , Franklin Aigbirhio 3 , Anju Sadhev 2 , Nicholas Bird 4 , Stefan Hader 3 , Victoria Warnes 4 , Kennedy Cruickshank 5,6 , Heok Cheow 4 , William Drake 1,2 , Mark Gurnell 3,4 & Morris Brown 1,2
1Queen Mary University London, London, United Kingdom; 2Saint Bartholomew’s Hospital, London, United Kingdom; 3Cambridge University, Cambridge, United Kingdom; 4Addenbrooke’s Hospital, Cambridge, United Kingdom; 5Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom; 6King’s College London, London, United Kingdom
Introduction: Our MATCH study demonstrated 11-C ligand MTO was non-inferior to adrenal vein sampling in predicting surgical outcomes of adrenalectomy in patients with PA. The 20-min half-life of 11-C imposes logistic constraints. We investigated an 18-F ligand, CETO; its 2h half-life permits use in any facility with fluorodeoxyglucose (FDG)-positron emission tomography (PET) scan capability.
Objective: To compare the detection of aldosterone-producing adenoma (APA), lateralisation ratio and biodistribution by CETO and MTO in PA patients.
Methods: 32 patients were scanned twice, separately, once each with MTO and CETO, each after 72 hours preparatory dexamethasone, in an extension study of MATCH. The uptake of the tracers was compared in nodules, normal adrenal and liver.
Results: There was no significant difference in the number of APAs detected by CETO (n=53) and MTO (n=58) (P=0.344). The radiologist’s interpretation of the likelihood of a unilateral APA (high, medium or low) was congruent in 30/32 scans. The average maximum standardised uptake value, by time of flight (SUVmaxTOF), in nodules was 14.4 and 16.4 in CETO and MTO respectively (P=<0.0001). CETO agreed with the lateralisation in all 20 scans identified to have high probability of unilateral APA by MTO. Of those scored with medium probability, only one disagreed on laterality, reporting a lateralisation ratio by MTO of 1.01 to the right and by CETO 1.06 to the left. Low probability outcomes of both scans were in agreement in all 6 subjects. SUVmaxTOF in the liver was significantly lower with CETO compared to MTO 3.95 and 14.47 respectively (P<0.0001).
Conclusions: CETO and MTO are strikingly similar in their ability to lateralise PA. CETO is the more favourable ligand, for clinical use, due to its longer half-life, and consequent potential for greater geographical distribution. 18-F CETO PET-CT imaging has the potential to increase lateralisation rates in PA.
Volume 86
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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