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  • Title: Adrenal scintigraphy in primary aldosteronism. Improved visualization after long-term pre-treatment with dexamethasone.
    Author: Hoefnagels WH, Claessens RA, Corstens FH, Drayer JI, Kazem I, Kloppenborg PW.
    Journal: Nuklearmedizin; 1981 Apr; 20(2):76-81. PubMed ID: 7243603.
    Abstract:
    Dexamethasone-modified adrenal scintigrams were performed on 13 patients with an aldosterone-producing adenoma and on one patient with an aldosterone-producing carcinoma. Adrenal scintigrams using 131I-19-Iodocholesterol were obtained after short pre-treatment with dexamethasone, while 131I-6 beta-Iodomethyl-19-Nor-Cholesterol scintigrams were performed after long-term pre-treatment with dexamethasone during 9-21 days. Using the former procedure the adrenal scintigrams correctly identified the adenoma in 3 of 8 patients, while with the latter procedure the adrenal scintigrams localized the adenomas in 8 out of 9 patients, including 3 patients in whom the former procedure had failed. The adrenal carcinoma was not visualized with 131I-6 beta-Iodomethyl-19-Nor-Cholesterol. Thus, the sensitivity of 131I-19-Iodocholesterol scintigrams to detect aldosterone-producing adenomas was only 37.5%. Uptake of radioactivity in the normal contralateral adrenal gland accounted for the low detection rate. On the other hand, the 131I-6 beta-Iodomethyl-19-Nor-Cholesterol scintigrams, performed after long-term pre-treatment with dexamethasone, had a sensitivity of 89%. It is suggested that long-term pre-treatment with dexamethasone contributed to the improved sensitivity by a more effective suppression of radioactivity uptake in the normal adrenal gland.
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