11C-metomidate PET in the diagnosis of adrenal masses and primary aldosteronism: a review of the literature

Cardenas, Stanley M Chen; Santhanam, Prasanna

doi:10.1007/s12020-020-02474-3

Cited by 17 publications

(13 citation statements)

References 24 publications

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“…Given its selectivity for these adrenal-specific targets, MTO labelled with [ 11 C] for PET imaging or [ 123 I] for single-photon emission computerized tomography (SPECT)/CT has been developed as an alternative tracer for functional adrenal imaging. 52 Evidence to date suggests that while MTO may be useful in distinguishing between cortical and noncortical adrenal lesions, its ability to differentiate benign from malignant adrenal tumors is limited. 52 Despite this, a subset of patients with metastatic ACC have been shown to demonstrate [ 123 I] MTO uptake, which has provided the rationale for trials of radionuclide-based systematic therapy in this subgroup (discussed below).…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

Section: Diagnostic Evaluationmentioning

confidence: 99%

“…52 Evidence to date suggests that while MTO may be useful in distinguishing between cortical and noncortical adrenal lesions, its ability to differentiate benign from malignant adrenal tumors is limited. 52 Despite this, a subset of patients with metastatic ACC have been shown to demonstrate [ 123 I] MTO uptake, which has provided the rationale for trials of radionuclide-based systematic therapy in this subgroup (discussed below). 53,54 Urine steroid metabolomics Limitations in the diagnostic accuracy of the imaging tests described above are reflected in the low prevalence of malignancy (<10%) in contemporary series of patients undergoing adrenalectomy for non-functioning incidentalomas.…”

Section: Imagingmentioning

confidence: 99%

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Adrenocortical carcinoma: current state of the art, ongoing controversies, and future directions in diagnosis and treatment

Shariq

McKenzie

2021

Therapeutic Advances in Chronic Disease

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Adrenocortical carcinoma (ACC) is a rare, aggressive malignancy with an annual incidence of ~1 case per million population. Differentiating between ACC and benign adrenocortical tumors can be challenging in patients who present with an incidentally discovered adrenal mass, due to the limited specificity of standard diagnostic imaging. Recently, urine steroid metabolite profiling has been prospectively validated as a novel diagnostic tool for the detection of malignancy with improved accuracy over current modalities. Surgery represents the only curative treatment for ACC, although local recurrence and metastases are common, even after a margin-negative resection is performed. Unlike other intra-abdominal cancers, the role of minimally invasive surgery and lymphadenectomy in ACC is controversial. Adjuvant therapy with the adrenolytic drug mitotane is used to reduce the risk of recurrence after surgery, although evidence supporting its efficacy is limited; it is also currently unclear whether all patients or a subset with the highest risk of recurrence should receive this treatment. Large-scale pan-genomic studies have yielded insights into the pathogenesis of ACC and have defined distinct molecular signatures associated with clinical outcomes that may be used to improve prognostication. For patients with advanced ACC, palliative combination chemotherapy with mitotane is the current standard of care; however, this is associated with poor response rates (RR). Knowledge from molecular profiling studies has been used to guide the development of novel targeted therapies; however, these have shown limited efficacy in early phase trials. As a result, there is an urgent unmet need for more effective therapies for patients with this devastating disease.

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Section: Diagnostic Evaluationmentioning

confidence: 99%

Section: Diagnostic Evaluationmentioning

confidence: 99%

Section: Imagingmentioning

confidence: 99%

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Adrenocortical carcinoma: current state of the art, ongoing controversies, and future directions in diagnosis and treatment

Shariq

McKenzie

2021

Therapeutic Advances in Chronic Disease

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“…Cluster 4 is related to clinical monitoring parameters and diagnosis in PA patients. Adrenal vein sampling (AVS), the most recommended procedure for lateralization in PA, has many limitations such as required technical expertise, increased costs, and potential complications ( 42 ). As a consequence, the development of new non-invasive imaging techniques and monitoring parameters is conducive to timely diagnosis, provides appropriate treatment, and prevents deleterious cardiovascular outcomes of PA, which is also a challenge for doctors and researchers in the future ( 2 , 43 ).…”

Section: Discussionmentioning

confidence: 99%

A Bibliometric Analysis of Primary Aldosteronism Research From 2000 to 2020

et al. 2021

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Thousands of papers on primary aldosteronism (PA) have been published in the last two decades. This study aimed to evaluate the research hotspots and future trends in PA research using bibliometric analysis. A total of 2,365 PA research papers between 2000 and 2020 were included. The dominant position of the United States in global PA research throughout this 20-year period was evident, and it was also the country most frequently involved in international cooperation. The University of Padua was the most productive institution and a leader in research collaboration. The Journal of Clinical Endocrinology & Metabolism was the most productive journal in terms of the number of publications on PA. Further, Mulatero P, Reincke M, Beuschlein F and Wu VC all made significant contributions to PA research. Five hotspots have been identified: (1) metabolic syndrome associated with PA; (2) molecular mechanisms of PA; (3) adrenal adenoma and adrenal cortex; (4) hypertension associated with PA; and (5) clinical monitoring parameters and diagnosis in patients with PA. Our results suggest that the molecular mechanisms of PA will remain research hotspots in the future. International collaboration is also expected to widen and deepen in the field of PA research.

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“…These experts agreed on the need to choose these methods based on genetic characterization (i.e. HIF2A/ VHL/MAX, SDHB mutations) (59,60). Finally, 11C-metomidate, an inhibitor of 11-b-hydroxylase, has been found to be highly specific for adrenocortical masses and a potentially useful PET tracer for the identification of PA and ACC.…”

Section: How To Searchmentioning

confidence: 99%

Grand Challenge in Adrenal Endocrinology: Is the Legacy of the Past a Challenge for the Future of Precision Medicine?

Chiodini

Gennari

2021

Front. Endocrinol.

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11C-metomidate PET in the diagnosis of adrenal masses and primary aldosteronism: a review of the literature

Cited by 17 publications

References 24 publications

Adrenocortical carcinoma: current state of the art, ongoing controversies, and future directions in diagnosis and treatment

Adrenocortical carcinoma: current state of the art, ongoing controversies, and future directions in diagnosis and treatment

A Bibliometric Analysis of Primary Aldosteronism Research From 2000 to 2020

Grand Challenge in Adrenal Endocrinology: Is the Legacy of the Past a Challenge for the Future of Precision Medicine?

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