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Accurate and timely localization of the source of aldosterone excess is crucial for management, in the form of curative adrenalectomy for unilateral aldosterone-producing adenoma or medical management for bilateral adrenal hyperplasia. The current diagnostic algorithm involves adrenal vein sampling (AVS) as the current \u201cgold standard\u201d in determining lateralization of aldosterone secretion, but its technical challenges present significant barriers to timely diagnosis and treatment. Recent technological advancements have contributed to the evolution of molecular imaging modalities such as 11C-metomidate positron emission tomography-computed tomography (11C-MTO PET-CT). Improved molecular imaging modalities hold significant potential to complement existing diagnostic pathways and refine treatment strategies for PA. This review evaluates different case scenarios comparing the utility of AVS with 11C-MTO PET-CT, suggesting a practical approach for its interpretation and highlighting the clinical decision-making process.<\/jats:p>","DOI":"10.1210\/clinem\/dgaf396","type":"journal-article","created":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T11:53:43Z","timestamp":1752926023000},"page":"3559-3568","source":"Crossref","is-referenced-by-count":7,"title":["Approach to the Patient With Primary Aldosteronism: Role of Molecular Imaging"],"prefix":"10.1210","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8832-0409","authenticated-orcid":false,"given":"Ada E D","family":"Teo","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, National University Hospital , Singapore 119074 ,","place":["Singapore"]},{"name":"Yong Loo Lin School of Medicine, National University of Singapore , Singapore 117597 ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2143-917X","authenticated-orcid":false,"given":"Hieu T N","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Changi General Hospital , Singapore 529889 ,","place":["Singapore"]},{"name":"Duke-National University of Singapore (NUS) Medical School , Singapore 169857 ,","place":["Singapore"]},{"name":"Department of Endocrinology, University Medical Center , Ho Chi Minh City 700000 ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1601-2391","authenticated-orcid":false,"given":"Chin Meng","family":"Khoo","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, National University Hospital , Singapore 119074 ,","place":["Singapore"]},{"name":"Yong Loo Lin School of Medicine, National University of Singapore , Singapore 117597 ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7665-2724","authenticated-orcid":false,"given":"Ismail","family":"Osman","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Changi General Hospital , Singapore 529889 ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7703-8707","authenticated-orcid":false,"given":"Aaron Kian-Ti","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital , Singapore 169854 ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8079-4618","authenticated-orcid":false,"given":"Roger S Y","family":"Foo","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore , Singapore 117597 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