NP-59 SPECT/CT Imaging in Stage 1 Hypertensive and Atypical Primary Aldosteronism: A 5-Year Retrospective Analysis of Clinicolaboratory and Imaging Features
Table 1
Detailed profile of all PA cases using NP-59 SPECT/CT imaging between April 2007 and March 2012 ().
Case
Age (year)
Sex
BP (mm Hg)
Class of anti-hypertensives
HTN Stage*
K# (mEq/L)
PAC# (ng/dL)
PRA# (ng/mL/hr)
ARR
TTKG
Confirmatory testing
CT (site, mm)
NP-59
Pathology (mm)
Improved outcomes
Planar
SPECT/CT
1
55
F
140/90
1
1
3.24
31.9
2.52
13
8.8
Saline loading (N) Captopril (N)
Normal
N
R
Micronodule (0.8)
PAC, K, BP
2
48
F
145/80
2
1
4.01
26.8
0.06
447
ND
Saline loading (N) Captopril (N)
L (17)
L
L
Adenoma (17)
PAC, PRA, BP
3‡
57
M
170/100
4
2
2.79
37.2
0.32
116
6.2
Saline loading (N)
L (puffy, 9)
N
L
Focal nodular Hyperplasia
PAC, PRA, K, BP
4
56
M
144/90
1
1
4.14
25.3
1.31
12
ND
ND
L (12)
N
L
Adenoma (10)
PAC, BP
5
39
M
206/115
4
2
2.2
27.5
1.68
16
8.2
ND
R (14)
N
R
Adenoma (12)
PAC, K, BP
6‡
27
F
150/88
2
1
4.32
29.3
1.62
18
ND
Captopril (N)
Normal
Faint
Bil
No operation†
PAC, BP
7
53
M
145/63
2
1
2.95
37.7
0.02
1885
ND
Saline loading (P) Captopril (P)
L (20)
N
L
Adenoma (18)
PAC, K, BP
8
61
F
150/93
1
1
3.84
19.9
0.39
51
ND
Captopril (N)
L (29)
L
L
Adenoma (26)
BP
9
63
M
136/79
1
1
3.4
17.4
1.39
13
ND
Saline loading (N) Captopril (N)
L (21)
L
L
Adenoma (22)
K, BP
10
40
F
150/90
1
1
3.1
5.36
1.99
2.7
6.3
ND
R (20)
R
R
Adenoma (20)
BP, K
11
75
M
181/92
6
2
3.9
8.42
0.21
39
ND
Captopril (N)
L (puffy, 10)
N
L
Adenoma (10)
BP
Abbreviations: BP: blood pressure; HTN: hypertension; K: potassium; PAC: plasma aldosterone concentration; PRA: plasma renin activity; ARR: aldosterone-renin-ratio; TTKG: transtubular potassium gradient; F: female; M: male; ND: not done; P: positive; N: negative; L: left; R: right; Bil: bilateral.
#Normalrange of PAC, PRA, and serum K is 3.7–24 ng/dL, 0.15–2.33 ng/mL/h, and 3.5 to 5.0 mEq/L, respectively.
*HTN stage according to JNC 7 report. †Only spironolactone therapy. ‡Patient 3 had stage 3 chronic kidney disease and patient 6 had stage 4 chronic kidney disease.
