68Ga-Pentixafor PET/CT for the Subtyping Diagnosis of Primary Aldosteronism

Inclusion Criteria: 1. PA diagnosis confirmed by at least one confirmatory test 2. willingness to undergo AVS and surgery 3. informed consent to participate in the study. Exclusion Criteria: 1. PA patients who met guideline criteria for bypassing AVS \[i.e. younger than 35 years old, with typical APA characteristics (plasma aldosterone \>300pg/ml, plasma renin \< 2·5mIU/l, serum potassium \<3·5mmol/l, CT indicated unilateral 1cm low-density adenoma); 2. failed adrenal vein cannulation during AVS; 3. Subtyping diagnosis was inconclusive based on AVS results (e.g. aldosterone/cortisol ratio in bilateral adrenal veins lower than the peripheral vein, or missing data); 4. pregnant or lactating women; 5. patients with a history of uncontrolled malignant tumor; 6. concurrent Cushing's syndrome \[including mild autonomous cortisol secretion: cortisol after 1mg dexamethasone suppression test (DST)\>138 nmol/l or cortisol after 2mg DST \>50 nmol/l or cortisol after 1mg DST 50-138 nmol/l plus adrenocorticotrophic hormone (ACTH)\<10pg/ml; 7. diagnosis of familial hyperaldosteronism; 8. imaging characteristics suggestive of pheochromocytoma or adrenal cortical carcinoma; 9. unsuitable for surgery, such as heart failure with New York Heart Association (NYHA) class III or IV, severe anemia (Hemoglobin\<60g/L), stroke or acute coronary syndrome within 3 months, severe ascites and cirrhosis, estimated glomerulus filtration rate\<30ml/min/m; 10. alcohol or drug abuse and mental disorders.