NP-59 test for preoperative localization of primary hyperaldosteronism.

Autor: Di Martino M; University Hospital La Princesa, Madrid, Spain. marcellodima@gmail.com., García Sanz I; University Hospital La Princesa, Madrid, Spain., Muñoz de Nova JL; University Hospital La Princesa, Madrid, Spain., Marín Campos C; University Hospital La Princesa, Madrid, Spain., Martínez Martín M; University Hospital La Princesa, Madrid, Spain., Domínguez Gadea L; University Hospital La Princesa, Madrid, Spain.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2017 Mar; Vol. 402 (2), pp. 303-308. Date of Electronic Publication: 2017 Feb 21.
DOI: 10.1007/s00423-017-1561-1
Abstrakt: Purpose: Adrenal venous sampling is generally considered the gold standard to identify unilateral hormone production in cases of primary hyperaldosteronism. The aim of this study is to evaluate whether the iodine-131-6-β-iodomethyl-19-norcholesterol (NP-59) test may represent an alternative in selected cases.
Methods: Patients submitted to laparoscopic adrenalectomy for suspected primary hyperaldosteronism (n = 27) were retrospectively reviewed. When nuclear medicine tests were preoperatively performed, their results were compared with the histopathologic findings and clinical improvement.
Results: Nuclear medicine tests were realized in 13 patients. In 11 (84.6%), a planar anterior and posterior NP-59 scintigraphy was performed and a SPECT/TC in two (15.4%). Scintigraphy indicated a preoperative lateralization in 12 out of 13 patients (92.3%). When the value of NP-59 tests was based on pathologic results, it showed a sensitivity of 90.9% and a positive predictive value of 83.3%. When the nuclear medicine test's performance was based on postoperative blood pressure control, both sensitivity and positive predictive value were 91.6%.
Conclusions: Nuclear medicine tests represent a useful tool in the preoperative localisation of primary hyperaldosteronism with a high sensitivity and positive predictive value. In patients with contraindications to adrenal venous sampling like contrast allergies, or when it is inconclusive, scintigraphy can represent a useful and non-invasive alternative.
Databáze: MEDLINE
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