68Ga-Pentixafor PET/CT Versus Adrenal Vein Sampling in Diagnosing Unilateral Subtype of Primary Aldosteronism Concurrent With Autonomous Cortisol Secretion (PREDICT)

Exclusion Criteria13

• Unable to complete 68Ga-Pentixafor PET/CT or AVS;
• Refusal of surgery or contraindications for surgery;
• PA patients who meet the by-passing AVS criteria \[i.e., younger than 35 years old, spontaneous hypokalemia, adrenal CT indicated unilateral low-density adenoma (≥1cm), plasma aldosterone \>300pg/ml\]
• Suspicion of familial hyperaldosteronism or Liddle syndrome. \[i.e., age \<20 years, hypertension and hypokalemia, or with family history\];
• Suspicion of pheochromocytoma or adrenal carcinoma;
• Patients with actively malignant tumor;
• Patients who have adrenalectomy history;
• Long-term use of glucocorticoids;
• Pregnant or lactating women; with alcohol or drug abuse and mental disorders;
• Congestive heart failure with New York Heart Association (NYHA) Functional Classification III or IV; History of serious cardiovascular or cerebrovascular disease (angina, myocardial infarction or stroke) in the past 3 months; Severe anemia (Hb\<60g/L); Serious liver dysfunction or chronic kidney disease aspartate aminotransferase (AST) or alanine transaminase (ALT) \>3 times the upper limit of normal, or estimated glomerular filtration rate (eGFR) \< 30 ml/min/1.73 m2); Systemic Inflammatory Response Syndrome (SIRS); Uncontrolled diabetes (FBG≥13.3 mmol/L); Obesity (BMI≥35 kg/m²) or Underweight (BMI≤18 kg/m²); Untreated aneurysm; Other comorbidity potentially interfering with treatment;
• Suspected PBMAH or PPNAD;
• Poor compliance or any other reason deemed unsuitable for inclusion by the investigators;
• Patients with adrenal insufficiency requiring hormone replacement therapy.