Dual-modality cardiac imaging facilitates accurate diagnosis and subtype classification in primary aldosteronism

NEW ORLEANS (June 22, 2025)— A novel integrated molecular imaging approach enables precise localization and quantification of heart damage, as well as accurate identification of disease subtypes. The dual PET/MR and PET/CMR technique also provides direct evidence supporting surgery as a cardio-protective intervention in these patients, offering a comprehensive strategy for managing primary aldosteronism. This research was presented at the Society of Nuclear Medicine and Molecular Imaging 2025 Annual Meeting.

Primary aldosteronism is a high-risk but treatable form of hypertension that can result in serious cardiac events. Consequently, patients with this condition require regular monitoring to evaluate heart health.

"Precise diagnosis and assessment of cardiac issues is critical for patients with primary aldosteronism," said Jie Ding, MD, doctor and researcher in the Department of Nuclear Medicine, Shanghai East Hospital, Tongji University, Shanghai, China. "Our study evaluated the effectiveness of this dual-modality approach integrating adrenal and cardiac imaging in disease management."

The prospective study included 30 patients with primary aldosteronism patients and 15 patients with primary hypertension. All participants underwent ⁶⁸Ga-Pentixafor PET/MR for adrenal imaging and ⁶⁸Ga-FAPI-04 PET/CMR for myocardial imaging. Standardized uptake values of the adrenal glands and myocardium were quantified and compared between groups. A subset of patients underwent follow-up ⁶⁸Ga-FAPI-04 PET/CMR imaging after adrenalectomy (removal of the adrenal glands).

The dual-modality imaging successfully identified aldosterone-producing adenoma from idiopathic hyperaldosteronism and was able to quantity myocardial fibrosis burden. Post-adrenalectomy ⁶⁸Ga-FAPI-04 imaging documented fibrosis regression, providing direct evidence for early intervention reversing target organ damage.

“This work revolutionizes the management of primary aldosteronism by enabling precise diagnosis and subtype classification, evaluating cardiovascular complications, and tracking treatment responses,” said Ding. “Altogether, it offers essential insights for guiding personalized therapy.”

Both ⁶⁸Ga-Pentixafor and ⁶⁸Ga-FAPI-04 represent established yet emerging PET tracers that have achieved significant clinical adoption. As such, Ding anticipates rapid translation of this dual-imaging method into routine practice.

Abstract 251148. “Characterization and Cardiac Assessment of Primary Aldosteronism Subtypes Using ⁶⁸Ga-Pentixafor PET/MR and ⁶⁸Ga-FAPI-04 PET/CMR,” Jie Ding and Jun Zhao, Shanghai East Hospital, Tongji University School of Medicine, Pudong, Shanghai, China.

Link to Abstract

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All 2025 SNMMI Annual Meeting abstracts can be found online.

About the Society of Nuclear Medicine and Molecular Imaging
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and medical organization dedicated to advancing nuclear medicine, molecular imaging, and theranostics—precision medicine that allows diagnosis and treatment to be tailored to individual patients in order to achieve the best possible outcomes.

SNMMI’s members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information, visit www.snmmi.org.

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