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Adrenocortical SPECT Using Iodine-131 NP-59

Nuclear Medicine and Endocrine and Metabolic Disease Services, Walter Reed Army Medical Center, Washington, DC; Department of Internal Medicine, Division of Nuclear Medicine, The University of Michigan Medical Center, Ann Arbor, Michigan

Correspondence: For correspondence or reprints contact: Antonio G. Balingit, MD, Nuclear Medicine Service, Department of Radiology, Walter Reed Army Medical Center, Washington, DC 20307-5001.

ABSTRACT

Adrenal scintigraphy with ¹³¹I-labeled 6-beta-iodomethyl-19-norcholesterol (NP-59) is a technically demanding and complex procedure. However, it can provide crucial and unique information about the functional status of the adrenal glands and guide the appropriate therapeutic management of patients with biochemically proven disease. Since the introduction of this new investigational drug, scintigraphic imaging has been performed using conventional planar techniques. We present an interesting case of primary aldosteronism in which planar scintigraphy and SPECT were combined in an attempt to increase the sensitivity of the study. SPECT revealed scintigraphic evidence of bilateral adrenocortical hyperplasia. Interestingly, the CT scan of this patient showed only an equivocal abnormality in the left adrenal gland, suggestive of an adenoma.

Key Words: primary aldosteronism • b-beta-iodomethyl-19-norcholesterol • SPECT

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