A new first-in-human study has validated a PET radiotracer that can effectively image overactive adrenal glands, offering an alternative to the highly invasive procedure currently utilized to diagnose primary aldosteronism. This approach, presented at the Society of Nuclear Medicine and Molecular Imaging 2026 Annual Meeting, could give physicians a noninvasive tool to tailor treatment plans for primary aldosteronism patients.
Primary aldosteronism, or Conn s syndrome, represents the largest fraction of patients with curable secondary hypertension. In primary aldosteronism, the adrenal gland overproduces aldosterone from cholesterol which then artificially increases blood pressure. Adrenal vein sampling, a highly invasive procedure performed at specialized facilities, is currently used for diagnosis, specifically to identify whether overproduction of aldosterone occurs in one or both adrenal glands.
One overactive adrenal gland can be removed to cure the overproduction, but if the overproduction is in both glands, patients require lifetime medication management. By using a PET radiotracer that targets cholesterol metabolism in the adrenal glands, physicians can noninvasively identify overactive glands to guide clinical decision‑making."
Peter Scott, PhD, Paul L Carson, PhD, Legacy Professor of Radiology at the University of Michigan in Ann Arbor
Building on preclinical research, this first-in-human study, led by Benjamin Viglianti, MD PhD, director of the Nuclear Medicine Division at University of Michigan, included nine patients (six healthy controls and three patients were previously diagnosed with overactive adrenal glands) who underwent PET imaging with the novel radiotracer 11C-Nevanimibe. In patients with adrenal pathology, the maximum standardized uptake values of both the liver and the adrenal glands were compared to healthy subjects.
The adrenal to liver uptake ratio in patients with overactive adrenal glands displayed an average of 1.2 compared to 0.7 in control subjects. Overall, the human biodistribution of 11C‑Nevanimibe closely mirrored preclinical findings, supporting successful translation to clinical use.
"This work further expands molecular imaging to benefit a population of patients currently lacking in non-invasive accessible diagnostic techniques," said Gina Kaup, graduate student in medicinal chemistry at the University of Michigan. "Additional clinical studies are underway to study dosimetry and efficacy of this tracer."
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