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Clinical Trial
. 2025 Sep 1;50(9):847-855.
doi: 10.1097/RLU.0000000000006014. Epub 2025 Jun 4.

First-in-Human Evaluation of [ 18 F]AldoView: A Highly Selective PET Tracer for Aldosterone Synthase Imaging in Primary Aldosteronism

Tingting Long  1 , Geru Liu  2 , Ming Zhou  1 , Zhen Zhang  2 , Yao Xiao  2 , Huizhu Chen  2 , Ning Peng  2 , Yuzhen Jin  1 , Yao He  3 , Yu Gan  3 , Zhi Chen  3 , Min Luo  2 , Chun Li  2 , Yuan Xiao  2 , Zehao Liu  2 , Min Guo  2 , Zhuying Xia  2 , Min Wang  2 , Jing Wang  4 , Longfei Liu  3 , Xianghang Luo  2 , Tiejian Jiang  2 , Shuo Hu  1   5   6
Affiliations
Clinical Trial

First-in-Human Evaluation of [ 18 F]AldoView: A Highly Selective PET Tracer for Aldosterone Synthase Imaging in Primary Aldosteronism

Tingting Long et al. Clin Nucl Med. .

Abstract

Objectives: Aldosterone synthase (CYP11B2) is overexpressed in primary aldosteronism (PA), making it a promising target for imaging. This first-in-human study evaluates the safety and feasibility of [ 18 F]AldoView, a highly selective PET tracer targeting CYP11B2, for PA subtyping.

Methods: Biodistribution and dosimetry of [ 18 F]AldoView were assessed in 3 healthy volunteers using whole-body PET/CT. Fifteen patients with adrenal lesions (13 with PA, 1 with Cushing's syndrome, and 1 with a nonfunctional adenoma) were enrolled. PET/CT scans were performed 60 minutes postinjection. Lesions were considered positive if tracer uptake exceeded normal adrenal tissue. Semi-quantitative analyses included maximum standardized uptake value (SUVmax), lesion-to-liver ratio (LLR), and lesion-to-adrenal ratio (LAR). Ten PA patients with positive imaging findings and 1 with Cushing's syndrome underwent adrenalectomy, and resected specimens were analyzed for CYP11B2 expression. This ongoing study is registered with the Chinese Clinical Trial Registry (ChiCTR2400093214).

Results: [ 18 F]AldoView was well-tolerated, with no adverse events. The effective dose was 0.012±0.0022 mSv/MBq. PET/CT identified positive lesions in all 10 PA patients, with a mean SUVmax of 15.73±8.57, LAR of 8.02±4.06, and LLR of 10.24±1.48. No positive lesions were observed in patients with idiopathic hyperaldosteronism, Cushing's syndrome, or nonfunctional adenomas. Positive lesions showed strong CYP11B2 staining on pathology, confirming aldosterone-producing adenomas (APA) or nodules (APN).

Conclusions: [ 18 F]AldoView PET/CT is safe and feasible for the imaging of APAs and APNs in PA patients. These results highlight its potential for noninvasive in vivo detection of CYP11B2, supporting its use in PA subtyping.

Keywords: CYP11B2; PET; primary aldosteronism.

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Conflict of interest statement

Conflicts of interest and sources of funding: This work was sponsored in part by the National Research Center for Clinical Medicine of Geriatric Diseases Clinical Research Fund (grant no. 2022LNJJ18 and grant no. 2022LNJJ12), the National Clinical Key Specialty Construction (Cultivation) Program Fund (grant no. Z2023056), the National Natural Science Foundation of China (grant no. 82272045), and the Science and Technology Innovation Program of Hunan Province (grant no. 2021RC4056). No other potential conflicts of interest relevant to this article was reported.

References

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