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Adrenal Imaging with Iodomethyl-Norcholesterol (I-131) in Primary Aldosteronism

University of Michigan Medical Center, Ann Arbor, Michigan

Correspondence: For reprints contact: William H. Beierwaltes, Div. of Nuclear Medicine, University of Michigan Medical Ctr., 1405 E. Ann St., Ann Arbor, MI 48109.

ABSTRACT

Twenty consecutive patients with primary aldosteronism (PAl) underwent dexamethasone suppression (DS) imaging with 6ß-[¹³¹I]-iodomethyl-19-norcholesterol (NP-59): a) to establish the value of the adrenal scan in distinguishing aldosteronomas from bilateral hyperplasia; b) to determine its ability to locate aldosteronomas when present; and c) to compare the efficacy of NP-59 in this current series against that reported previously with NM-145 in PAl. Ten of twenty patients had an aldosteronoma, five had histologically confirmed hyperplasia, and five had presumed hyperplasia. With NP-59, nine of ten tumors were correctly located (90%), correct distinction between tumor and hyperplasia was possible in 90%, and a locating DS scan was specific for tumor in 90%. In a combined series of different patients with PAl imaged with NM-145, 21 of 25 tumors were correctly located (84%), tumor was distinguished from hyperplasia in 86%, and the specificity of the localizing scan was 92%. The imaging delay required from tracer injection to attainment of an interpretable scan averaged 2.7 days with NP-59 and 4.8 days with NM-145. In summary, no significant differences were noted in the clinical results achieved with these two agents. The preferred agent is NP-59, since the study can be completed with less average time delay than is possible with NM-145.

FOOTNOTES

^* Current address: Nuclear Medicine Dept., William Beaumont Hospital, Royal Oak, MI 48072.