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<p>ACTH-independent Cushing syndrome (CS), a form of endogenous CS and an adrenal cause of hypertension, presents specific challenges in localizing cortisol-producing lesions. This study compared the diagnostic utility of <sup>68</sup>Ga-Pentixafor PET/CT for lesion localization between ACTH-independent CS and non-functioning adrenal adenomas (NFAA). We retrospectively analyzed 73 subjects (52 with ACTH-independent CS; 21 with NFAA) undergoing <sup>68</sup>Ga-Pentixafor PET/CT. Visual analysis demonstrated high diagnostic accuracy, with a sensitivity of 91.95%, a specificity of 95.24%, and a Youden index of 0.87. In semi-quantitative analysis, the lesion-to-adrenal ratio (LAR) showed superior performance compared to SUVmax and lesion-to-liver ratio (LLR). Using a diagnostic cutoff of SUVmax &gt; 1.30, the sensitivity and specificity were 100% and 76.20%, respectively, supported by an AUC of 0.935 (<i>P</i> &lt; 0.001) and a Youden index of 0.762. <sup>68</sup>Ga-Pentixafor PET/CT effectively localizes functional adrenal lesions in ACTH-independent CS with high accuracy, supporting its role in guiding targeted management and surgical planning.</p><p></p>

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The value of 68Ga-Pentixafor PET/CT targeting CXCR4 in the diagnosis of ACTH-independent Cushing syndrome

  • 期刊论文

  • 发表日期：

    2026年2月4日

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  • Zhen Zhang,
  • Chun Li,
  • Yao Xiao,
  • Ning Peng,
  • Geru Liu,
  • Huizhu Chen,
  • Qianwen Ye,
  • Mengling Zhen,
  • Yao He,
  • Tiejian Jiang

摘要

ACTH-independent Cushing syndrome (CS), a form of endogenous CS and an adrenal cause of hypertension, presents specific challenges in localizing cortisol-producing lesions. This study compared the diagnostic utility of 68Ga-Pentixafor PET/CT for lesion localization between ACTH-independent CS and non-functioning adrenal adenomas (NFAA). We retrospectively analyzed 73 subjects (52 with ACTH-independent CS; 21 with NFAA) undergoing 68Ga-Pentixafor PET/CT. Visual analysis demonstrated high diagnostic accuracy, with a sensitivity of 91.95%, a specificity of 95.24%, and a Youden index of 0.87. In semi-quantitative analysis, the lesion-to-adrenal ratio (LAR) showed superior performance compared to SUVmax and lesion-to-liver ratio (LLR). Using a diagnostic cutoff of SUVmax > 1.30, the sensitivity and specificity were 100% and 76.20%, respectively, supported by an AUC of 0.935 (P < 0.001) and a Youden index of 0.762. 68Ga-Pentixafor PET/CT effectively localizes functional adrenal lesions in ACTH-independent CS with high accuracy, supporting its role in guiding targeted management and surgical planning.