{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:15:37Z","timestamp":1791249337675,"version":"4.1.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The study aimed to investigate the diagnostic value of <jats:sup>18<\/jats:sup>F-AlF-NOTA-Pentixafor PET\/CT in subtyping primary aldosteronism (PA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study enrolled 88 patients with PA or nonfunctional adenoma (NFA) for <jats:sup>18<\/jats:sup>F-Pentixafor PET\/CT scan. Of these, 20 patients underwent adrenal venous sampling (AVS), and 65 underwent adrenalectomy and postoperative follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 88 patients, 76 were diagnosed with unilateral PA (UPA), 4 were diagnosed with bilateral PA (BPA), and 8 were diagnosed with NFA, resulting in a total of 95 lesions. To identify UPA, visual analysis received a specificity of 94.12% and a sensitivity of 89.74%. The optimal cutoff values for SUV<jats:sub>max<\/jats:sub> at 5.45, the lesion-to-normal adrenal ratio (LAR) at 1.43, and lesion-to-liver ratio (LLR) all yielded a specificity of 100% and a sensitivity of 79.49%, 83.33%, and 80.77%, respectively. In 15 adrenal lesions with similar uptake to contralateral and adjacent normal adrenal tissue (defined as warm lesions), 7 were confirmed as UPA, 4 were confirmed as BPA, and 4 were confirmed as NFA. Furthermore, among the 20 patients who underwent AVS, the concordance rate of AVS and PET\/CT visual analysis for PA subtyping was 65.00%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The CXCR4-targeted <jats:sup>18<\/jats:sup>F-AlF-NOTA-pentixafor PET\/CT is a valuable noninvasive tool for diagnosing UPA, demonstrating high sensitivity and specificity. More attention should be paid to warm adrenal lesions for their high diagnostic ambiguity probability.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1533295","type":"journal-article","created":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T05:21:32Z","timestamp":1740633692000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["The value of targeted CXCR4 18F-AlF-NOTA-pentixafor PET\/CT for subtyping primary 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