[11C]Metomidate PET-CT vs Usual Care for People With Primary Aldosteronism: a Proof-of-concept Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Edith WK Chow, MBChB
- Phone Number: +85235051601
- Email: edithwkchow@cuhk.edu.hk
Study Locations
-
-
-
Shatin, Hong Kong
- Chinese University of Hong Kong
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Diagnosis of PA made based on Endocrine Society guidelines:
Participants should demonstrate a positive screening test for primary aldosteronism, defined as:
- Paired measurement of renin and aldosterone demonstrating a raised aldosterone-to-renin ratio >550 pmol/L/ng/mL/h AND
- Suppressed renin <=1ng/ml/h
AND participants should demonstrate autonomous aldosterone secretion following salt-loading confirmatory tests, defined as:
- 1) Non-suppressed aldosterone >162pmol/L following seated saline infusion OR
- 2) raised 24-hour urine aldosterone >38 nmol/d following oral salt loading test (17)
- For participants with spontaneous hypokalemia with renin below detection level and plasma aldosterone > 416 pmol/L(by LC-MS) at screening, the above confirmatory tests can be omitted due to high pre-test probability as proposed by latest guidelines (10).
- Adrenal nodule on CT
Exclusion Criteria:
- Unable to give informed consent
- Participants who neither agree to AVS nor MTO-PET
- Patients who indicate they will not proceed to adrenalectomy
- Patients contraindicated for mineralocorticoid receptor antagonists
- Patients who are unable/unwilling or contraindicated for dexamethasone required for MTO-PET
- Estimated GFR < 30 ml/min/1.73m2
- Any illness or condition that is considered unfit for study by the investigators
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: MTO-PET
Participant will receive [11C]metomidate PET-CT as the first lateralisation procedure
|
Metomidate labelled with C11H3([11C]Metomidate) is used as a radiotracer in PET-CT to detect expression of CYP11B1 and CYP11B2 in adrenal cortex.
|
|
Active Comparator: Usual Care
Participants will receive adrenal venous sampling as per usual care as his/her first lateralisation strategy
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Adrenal venous sampling is an invasive procedure that involves insertion of a catheter to adrenal veins to determine if one side of the adrenal is producing excess aldosterone hormones compared to the other side.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Compare the proportion of people who achieved complete or partial clinical success
Time Frame: at 6 and 12 months
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Clinical success is defined by Primary Aldosteronism Surgical Outcome criteria for people who underwent surgery and Primary Aldosteronism Medical Treatment Outcome criteria for those who received mineralocorticoid receptor antagonist
|
at 6 and 12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2026.106
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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