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
HF Chan, LF Cheng
Hong Kong J Radiol 2014;17:176-81
DOI: 10.12809/hkjr1414230
Objectives: To evaluate the usefulness of NP-59 (131I-iodocholesterol) scan as a non-invasive alternative to adrenal venous sampling in the diagnosis of Conn’s syndrome and lateralisation of aldosterone production.
Methods: The electronic patient records of 39 consecutive patients who were referred for NP-59 scan in our centre between 1 January 2007 and 31 December 2012 were reviewed. The results of NP-59 scan, biochemical test, subsequent treatment plan, histopathology findings, and clinical outcome were evaluated.
Results: Of the 39 patients, 17 had successful lateralisation of aldosterone production by NP-59 scan. Of these 17 patients, 11 had unilateral adrenalectomy, six patients refused surgery. Unilateral adrenalectomy treatment success was reported in all 11 (100%) patients who had lateralisation of aldosterone source by NP-59 scan.
Conclusion: Our study has shown that NP-59 scan as a single imaging investigation has excellent positive predictive value in the diagnosis of aldosterone-producing adenoma (Conn’s syndrome) and NP-59 scan can be used as an alternative to adrenal venous sampling.
中文摘要
NP-59（131I-iodocholesterol）掃描替代腎上腺靜脈採血診斷原發性醛固酮增多症：五年回顧性研究
陳可鋒、鄭力暉
目的：探討NP-59（131I-iodocholesterol）掃描作為替代腎上腺靜脈採血的一種非侵入性工具，用於診斷康氏症（Conn’s syndrome）和醛固酮偏側分泌的有效性。
方法：回顧於2007年1月1日至2012年12月31日期間轉介至本中心進行NP-59掃描的連續39例病人的電子病歷。評估NP-59掃描結果、生化檢驗、隨後的治療計劃、組織病理學結果和臨床結果。
結果：39名患者中，NP-59掃描成功檢測單側醛固酮分泌17例。這17名患者中，11人接受單側腎上腺切除術，餘下6人拒絕接受手術。11例NP-59掃描檢測到單側醛固酮分泌源的病人的單側腎上腺切除術治療成功率達至100%。
結論：本研究顯示NP-59掃描作為一種單獨的影像檢查，其診斷醛固酮分泌腺瘤（康氏症）具有極佳陽性預測值。此外，NP-59掃描可用作腎上腺靜脈血採樣的替代檢查。