Faba bean and pea harvest index estimations using aerial-based multimodal data and machine learning algorithms.

Early and high-throughput estimations of the crop harvest index (HI) are essential for crop breeding and field management in precision agriculture; however, traditional methods for measuring HI are time-consuming and labor-intensive. The development of unmanned aerial vehicles (UAVs) with onboard sensors offers an alternative strategy for crop HI research. In this study, we explored the potential of using low-cost, UAV-based multimodal data for HI estimation using red-green-blue (RGB), multispectral (MS), and thermal infrared (TIR) sensors at 4 growth stages to estimate faba bean (Vicia faba L.) and pea (Pisum sativum L.) HI values within the framework of ensemble learning. The average estimates of RGB (faba bean: coefficient of determination [R2] = 0.49, normalized root-mean-square error [NRMSE] = 15.78%; pea: R2 = 0.46, NRMSE = 20.08%) and MS (faba bean: R2 = 0.50, NRMSE = 15.16%; pea: R2 = 0.46, NRMSE = 19.43%) were superior to those of TIR (faba bean: R2 = 0.37, NRMSE = 16.47%; pea: R2 = 0.38, NRMSE = 19.71%), and the fusion of multisensor data exhibited a higher estimation accuracy than those obtained using each sensor individually. Ensemble Bayesian model averaging provided the most accurate estimations (faba bean: R2 = 0.64, NRMSE = 13.76%; pea: R2 = 0.74, NRMSE = 15.20%) for whole growth stage, and the estimation accuracy improved with advancing growth stage. These results indicate that the combination of low-cost, UAV-based multimodal data and machine learning algorithms can be used to estimate crop HI reliably, therefore highlighting a promising strategy and providing valuable insights for high spatial precision in agriculture, which can help breeders make early and efficient decisions.

Hardware implementation of a mirror array-based optical intelligent reflecting surface for VLC: prototype and experimental results.

Faced with growing demands for high-speed and reliable communication systems, optical intelligent reflecting surfaces (OIRS) have recently attracted a lot of interest in visible light communication (VLC). With potential applications in a variety of scenarios, including indoor wireless communications and the Internet of Things (IoT), OIRS is expected to have a transformative impact on optical wireless communications. However, current research is predominantly theoretical, and the hardware implementation of OIRS is insufficient. Therefore, this paper introduces an OIRS prototype based on a mirror array, which is capable of adjusting the reflected lightwave by manipulating the orientation of individual OIRS units to realize an adjustable optical wireless communication environment. Additionally, a hardware platform with a configurable control system for OIRS-based VLC has been developed in this paper. Finally, experimental results demonstrate significant improvements in the amplitude of the received signal and the signal-to-noise ratio of the developed prototype, thereby verifying the enhancement of communication efficiency and the potential of practical OIRS deployment.

New Chlorine-Containing Sesquiterpenoid from Artemisia Blepharolepis.

One new chlorinated sesquiterpenoid (compound 1, ablepharolide) and twenty-one known compounds were obtained from the aerial parts of Artemisia blepharolepis. Their structures were established by spectroscopic methods and the absolute configuration was further determined by single-crystal X-ray diffraction analysis for ablepharolide. Ablepharolide is a rare sesquiterpenoid with a 4-methyl-7-isopropyl-9-ethyl-perhydroindene skeleton that incorporates a chlorine atom. It significantly inhibited the growth of MCF-7 cells with IC50 value of 8.34±0.77 µM. Further investigations demonstrated that ablepharolide induced morphological changes in MCF-7 cells, inhibited proliferation in a time- and dose-dependent manner. Furthermore, western blot analysis revealed that ablepharolide induced a significant increase in cleaved caspase-8, cleaved caspase-3 and cleaved poly(ADP-ribose) polymerase (PARP) in MCF-7 cells. All of these results supported that ablepharolide induced exogenous apoptosis in MCF-7 cells.

Neutrophil-to-lymphocyte ratio is associated with carotid intraplaque neovascularization in asymptomatic carotid stenosis patients.

BACKGROUND AND PURPOSE: Neutrophil-to-lymphocyte ratio (NLR) has been suggested as an available systemic inflammatory biomarker. This study aims to evaluate whether intraplaque neovascularization assessed by contrast-enhanced ultrasound (CEUS) is associated with NLR in asymptomatic carotid stenosis patients. MATERIALS AND METHODS: One hundred and forty-four asymptomatic patients with carotid luminal stenosis >30% were assessed using contrast-enhanced ultrasound imaging. The contrast enhancement within the plaque was classified on a visual semiquantitative grading scale. The data collected included the patient's risk factors, laboratory results, cardiovascular disease history, and drug use history. Univariate and multivariate analyses were assessed to identify independent factors related to intraplaque neovascularization with adjustment for potential confounders. RESULTS: Patients with CEUS grade 2 plaques had a higher level of LDL-C (p < .001), neutrophil count (p < .001), and blood glucose (p = .005), but lower level of lymphocyte count (p = .021). The presence of grade 2 plaques was significantly associated with high NLR values (OR 1.21, 95% CI 1.03-1.43, p = .017). Patients were divided into four groups according to the quartile of NLR values. Compared to the patients in the first quartile of NLR (<1.73), the patients in the fourth NLR quartile (≥3.38) were characterized by the most prevalence of CEUS grade 2 plaques (OR 4.55, 95% CI 1.69-12.25, p = .003). Multivariate logistic regression analysis after adjusting various variables demonstrated NLR remained an independent risk factor for the presence of CEUS grade 2 plaques. CONCLUSION: Intraplaque neovascularization is significantly associated with NLR in asymptomatic carotid stenosis patients.

S100P contributes to promoter demethylation and transcriptional activation of SLC2A5 to promote metastasis in colorectal cancer.

BACKGROUND: SLC2A5 is a high-affinity fructose transporter, which is frequently upregulated in multiple human malignant tumours. However, the function and molecular mechanism of SLC2A5 in colorectal cancer (CRC) remain unknown. METHODS: We detected the expression levels of SLC2A5 in CRC tissues and CRC cell lines by western blotting, qRT-PCR and immunohistochemistry. CRC cell lines with stable overexpression or knockdown of SLC2A5 were constructed to evaluate the functional roles of SLC2A5 in vitro through conventional assays. An intrasplenic inoculation model was established in mice to investigate the effect of SLC2A5 in promoting metastasis in vivo. Methylation mass spectrometry sequencing, methylation specific PCR, bisulphite sequencing PCR, ChIP-qPCR and luciferase reporter assay were performed to investigate the molecular mechanism underlying transcriptional activation of SLC2A5. RESULTS: We found that SLC2A5 was upregulated in colorectal tumour tissues. Functionally, a high level of SLC2A5 expression was associated with increased invasion and metastasis capacities of CRC cells both in vitro and in vivo. Mechanistically, we unveiled that S100P could integrate to a specific region of SLC2A5 promoter, thereby reducing its methylation levels and activating SLC2A5 transcription. CONCLUSIONS: Our results reveal a novel mechanism that S100P mediates the promoter demethylation and transcription activation of SLC2A5, thereby promoting the metastasis of CRC.

BET bromodomain is a novel regulator of TAZ and its activity.

Transcriptional coactivator with PDZ-binding motif (TAZ) is a key transcriptional mediator of Hippo signaling that has been recently reported to mediate Wnt-activated transcription and serve as a component to suppress canonical Wnt/ß-catenin activity. The Bromodomain and Extra-terminal domain (BET) family of proteins can recognize the acetylated lysine chain on histones and plays a critical role in transcriptional regulation. However, the mechanisms underlying transcriptional repression by the BET bromodomain are poorly understood. Here, we found that BET bromodomain inhibition upregulated TAZ protein and its transcriptional output, independent of its well-established role as a mediator of Hippo and Wnt signaling. Additionally, JQ1, a synthetic BET inhibitor, suppressed Wnt/ß-catenin activity by upregulating TAZ. Although JQ1 upregulated TAZ, which is known to promote cell proliferation, it drastically suppressed the growth of colon cancer cells by inducing cell cycle arrest. Collectively, our study identified an unexpected transcriptional repression function of the BET bromodomain and a novel mechanism for TAZ upregulation.

Newly evidence across the world on how climate financing helps in ensuring a greener future.

Investing in climate change mitigation and adaptation has become a promising approach to address the negative impacts of climate change on the environment and to encourage efforts to adjust to changing conditions. Climate funding is a kind of foreign aid that seeks to reduce carbon dioxide emissions and promote ecologically sustainable economic development. However, it is not quite clear to what extent it helps recipient countries transition to low-carbon pathways. This research examines the worldwide flow of climate finance from 1999 to 2017 to determine the impact of climate funds on reducing carbon emissions and promoting sustainable development in recipient countries. The data suggest a potential correlation between climate funding and the reduction of carbon emissions, with investments in mitigation seeming to have a greater impact than spending on adaptation. Furthermore, countries that have achieved significant economic progress and Small Island developing states stand to benefit more from climate aid aimed at reducing emissions. This is due to the fact that both sorts of nations exhibit greater rates of economic growth. These results are significant for policymakers, who may use them to accelerate the transition to net-zero combustion levels and enhance environmental sustainability.

Multichannel Sandstone Thin Sections Identification Based on Improved DeepLab V3 Plus Neural Network.

As an unconventional natural gas resource, tight sandstone gas is primarily stored in the minuscule pores between rocky sand grains. A thorough understanding of the pore structure characteristics of tight sandstone reservoirs is essential for formulating an extraction plan and enhancing the efficiency of gas field development. The pore structure and mineral composition in the sandstone can be directly observed by thin sections. Nevertheless, previous approaches for the automated identification of sandstone thin sections exhibit certain limitations including slow identification, low accuracy, and challenges in the recognition of particle sizes. To achieve more accurate and convenient mineral component identification, this study introduces a multichannel identification method built upon the enhanced DeepLab V3 Plus model. Initially, all 224 × 224 × 3 cross-polarized light (CPL) and orthogonal polarized light (XPL) sandstone thin sections were amalgamated into 224 × 224 × 6 multichannel (six channels) images. Subsequently, multiple networks were employed to train the three polarized data sets, and the optimal semantic segmentation architecture and data set were selected through filtering. Following that, embedding the attention mechanism into the semantic segmentation network enhanced the identification accuracy. Ultimately, mineral sizes were calculated to enable more precise classification and naming of sandstone thin sections. The results show that the new method outperforms in terms of recognition accuracy, achieving 89.8% for Mean PA and 81.2% for Mean IOU. The novel approach's enhanced level of detailing enables more precise identification of mineral composition and pore structure, a crucial aspect in evaluating reservoirs and predicting oil and gas production. It can also provide new insights into identifying and categorizing other thin sections with similar compositions.

Association of cardiovascular risk factors and intraplaque neovascularization in symptomatic carotid plaque.

Background and purpose: Cardiovascular risk factors are known to contribute to the formation of atherosclerotic plaques, which can result in carotid stenosis. However, the extent to which these factors are associated with intraplaque neovascularization, a key indicator of plaque vulnerability, remains unclear. To investigate this relationship, a study was conducted utilizing contrast-enhanced ultrasound (CEUS) to assess intraplaque neovascularization in symptomatic patients. Methods: A cohort of 157 symptomatic patients underwent evaluation using Contrast-Enhanced Ultrasound (CEUS) imaging to assess carotid intraplaque neovascularization, which was quantified based on the degree of plaque enhancement. The collected data encompassed baseline patient characteristics, results from biochemical examinations, cardiovascular risk factors, and medication usage history. Regression analyses were conducted to elucidate the relationship between carotid plaque neovascularization and various cardiovascular risk factors. Results: Patients with intraplaque neovascularization were more prone to have diabetes mellitus (OR 3.81, 95% CI 1.94-7.46, p < 0.001), dyslipidemia (OR 2.36, 95% CI 1.22-4.55, p = 0.011) and hypertension (OR 2.92, 95% CI 1.50-5.71, p = 0.002). Smoking increased the risk of having intraplaque neovascularization (OR 2.25, 95% CI 1.12-4.54, p = 0.023). Treatment with statins was significantly lower in patients with intraplaque neovascularization (OR 0.37, 95% CI 0.19-0.72, p = 0.003). In the multivariate analysis, diabetes mellitus (OR 3.27, 95% CI 1.10-9.78, p = 0.034) was independently related to the presence of intraplaque neovascularization. Meanwhile, compared to the patients in the first tertile of serum glucose (< 6.20 mmol/L), the patients in the third tertile (> 13.35 mmol/L) had the most significance of intraplaque neovascularization (OR 5.55, 95% CI 1.85-16.66, p = 0.002). Conclusion: The findings indicated that diabetes mellitus is a significant cardiovascular risk factor that is strongly associated with carotid intraplaque neovascularization.

Genetically predicted N-Acetyl-L-Alanine mediates the association between CD3 on activated and secreting Tregs and Guillain-Barre syndrome.

Objective: This study sought to explore the potential causal relationships among immune cell traits, Guillain-Barre syndrome (GBS) and metabolites. Methods: Employing a two-sample Mendelian randomization (MR) approach, the study investigated the causal associations between 731 immune cell traits, 1400 metabolite levels and GBS leveraging summary-level data from a genome-wide association study (GWAS). To ensure the reliability of our findings, we further assessed horizontal pleiotropy and heterogeneity and evaluated the stability of MR results using the Leave-one-out method. Results: This study revealed a causal relationship between CD3 on activated & secreting Tregs and GBS. Higher CD3 on activated and secreting Regulatory Tregs increased the risk of GBS (primary MR analysis odds ratio (OR) 1.31/SD increase, 95% confidence interval (CI) 1.08-1.58, p = 0.005). There was no reverse causality for GBS on CD3 on activated & secreting Tregs (p = 0.36). Plasma metabolite N-Acetyl-L-Alanine (ALA) was significantly positively correlated with GBS by using the IVW method (OR = 2.04, 95% CI, 1.26-3.30; p = 0.00038). CD3 on activated & secreting Tregs was found to be positively associated with ALA risk (IVW method, OR, 1.04; [95% CI, 1.01-1.07], p = 0.0078). Mediation MR analysis indicated the mediated proportion of CD3 on activated & secreting Tregs mediated by ALA was 10% (95%CI 2.63%, 17.4%). Conclusion: In conclusion, our study identified a causal relationship between the level of CD3 on activated & secreting Tregs and GBS by genetic means, with a considerable proportion of the effect mediated by ALA. In clinical practice, thus providing guidance for future clinical research.

TODO-Net: Temporally Observed Domain Contrastive Network for 3-D Early Action Prediction.

Early action prediction aiming to recognize which classes the actions belong to before they are fully conveyed is a very challenging task, owing to the insufficient discrimination information caused by the domain gaps among different temporally observed domains. Most of the existing approaches focus on using fully observed temporal domains to "guide" the partially observed domains while ignoring the discrepancies between the harder low-observed temporal domains and the easier highly observed temporal domains. The recognition models tend to learn the easier samples from the highly observed temporal domains and may lead to significant performance drops on low-observed temporal domains. Therefore, in this article, we propose a novel temporally observed domain contrastive network, namely, TODO-Net, to explicitly mine the discrimination information from the hard actions samples from the low-observed temporal domains by mitigating the domain gaps among various temporally observed domains for 3-D early action prediction. More specifically, the proposed TODO-Net is able to mine the relationship between the low-observed sequences and all the highly observed sequences belonging to the same action category to boost the recognition performance of the hard samples with fewer observed frames. We also introduce a temporal domain conditioned supervised contrastive (TD-conditioned SupCon) learning scheme to empower our TODO-Net with the ability to minimize the gaps between the temporal domains within the same action categories, meanwhile pushing apart the temporal domains belonging to different action classes. We conduct extensive experiments on two public 3-D skeleton-based activity datasets, and the results show the efficacy of the proposed TODO-Net.

Oxidation-induced graded bandgap narrowing in Two-dimensional tin sulfide for high-sensitivity broadband photodetection.

Two-dimensional (2D) layered group-IV monochalcogenides with large surface-to-volume ratio and high surface activity make that their structural and optoelectronic properties are sensitive to air oxidation. Here, we report the utilization of oxidation-induced gradient doping to modulate electronic structures and optoelectronic properties of 2D group-IV monochalcogenides by using SnS nanoplates grown by physical vapor deposition as a model system. By a precise control of oxidation time and temperature, the structural transition from SnS to SnSOx could be driven by the layer-by-layer oxygen doping and intercalation. The resulting SnSOx with a graded narrowing bandgap exhibits the enhanced optical absorption and photocurrent, leading to the fabricated SnSOx photodetector with remarkable photoresponsivity and fast response speed (<64 µs) at a broadband spectrum range of 520-1550 nm. The peak responsivity (7294 A/W) and detectivity (9.54 × 109 Jones) of SnSOx device are at least two orders of magnitude larger than those of SnS photodetector. Moreover, its photodetection performance can be competed with state-of-the-art of 2D materials-based photodetectors. This work suggests that the air oxidation could be utilized as an efficient strategy to engineer the electronic and optical properties of SnS and other 2D group-IV monochalcogenides for the development of high-performance broadband photodetectors.

Mitochondrial Morphology and Function Abnormality in Ovarian Granulosa Cells of Patients with Diminished Ovarian Reserve.

In this study, we examined the changes in the mitochondrial structure and function in cumulus granulosa cells of patients with diminished ovarian reserve (DOR) to explore the causes and mechanisms of decreased mitochondrial quality. The mitochondrial ultrastructure was observed by transmission electron microscope, and the function was determined by detecting the ATP content, reactive oxygen species (ROS) levels, the number of mitochondria, and the mitochondrial membrane potential. The expression of ATP synthases in relation to mitochondrial function was analyzed. Additionally, protein immunoblotting was used to compare the expression levels of mitochondrial kinetic protein, the related channel protein in the two groups. Patients with DOR had abnormal granulosa cell morphology, increased mitochondrial abnormalities, decreased mitochondrial function, and disturbed mitochondrial dynamics. Additionally, the silent information regulator 1 (SIRT1)/phospho-AMP-activated protein kinase (P-AMPK)-peroxisome proliferator-activated receptor-gamma coactivator 1 alpha (PGC-1α) pathway expression was decreased, which was speculated to be associated with the decreased mitochondrial mass in the DOR group. The mitochondrial mass was decreased in granulosa cells of patients in the DOR group. The mitochondrial dysfunction observed in granulosa cells of patients in the DOR group may be associated with dysregulation of the SIRT1/P-AMPK-PGC-1α-mitochondrial transcription factor A (TFAM) pathway.

Membrane-associated NRPM proteins are novel suppressors of stomatal production in Arabidopsis.

In Arabidopsis, stomatal development and patterning require tightly regulated cell division and cell-fate differentiation that are controlled by key transcription factors and signaling molecules. To identify new regulators of stomatal development, we assay the transcriptomes of plants bearing enriched stomatal lineage cells that undergo active division. A member of the novel regulators at the plasma membrane (NRPM) family annotated as hydroxyproline-rich glycoproteins was identified to highly express in stomatal lineage cells. Overexpressing each of the four NRPM genes suppressed stomata formation, while the loss-of-function nrpm triple mutants generated severely overproduced stomata and abnormal patterning, mirroring those of the erecta receptor family and MAPKKK yoda null mutants. Manipulation of the subcellular localization of NRPM1 surprisingly revealed its regulatory roles as a peripheral membrane protein instead of a predicted cell wall protein. Further functional characterization suggests that NRPMs function downstream of the EPF1/2 peptide ligands and upstream of the YODA MAPK pathway. Genetic and cell biological analyses reveal that NRPM may promote the localization and function of the ERECTA receptor proteins at the cell surface. Therefore, we identify NRPM as a new class of signaling molecules at the plasma membrane to regulate many aspects of plant growth and development.

Mechanisms of oral microflora in Parkinson's disease.

Parkinson's disease (PD) is a common neurodegenerative disease with complex pathogenesis and no effective treatment. Recent studies have shown that dysbiosis of the oral microflora is closely related to the development of PD. The abnormally distributed oral microflora of PD patients cause degenerative damage and necrosis of dopamine neurons by releasing their own components and metabolites, intervening in the oral-gut-brain axis, crossing the biofilm, inducing iron dysregulation, activating inter-microflora interactions, and through the mediation of saliva,ultimately influencing the development of the disease. This article reviews the structure of oral microflora in patients with PD, the mechanism of development of PD caused by oral microflora, and the potential value of targeting oral microflora in developing a new strategy for PD prevention, diagnosis and treatment.

Age-related alterations in vortex veins on indocyanine green angiography.

To determine age-related alterations in vortex veins in healthy subjects. A total of 228 healthy subjects (aged 4 to 86 years) were recruited and divided into four groups (G1, <21 years; G2, 21-40 years; G3, 41-60 years; and G4, 61-86 years). The clinical characteristics of the participants were recorded, and parameters including the number of vortex vein roots (NVVR), the central vortex vein diameter (CVVD), the mean root area of the vortex vein (MRAVV), and the weighted mean of the thickest branch diameter (WMTBD) were obtained by marking the vortex veins on indocyanine green angiography (ICGA). The NVVR in the age group over 60 years old was significantly lower than that in other age groups (P < 0.05). The CVVD, MRAVV, and WMTBD of all age groups increased with increasing age (P < 0.05). The NVVR was unevenly distributed among the quadrants (P < 0.001). The proportions of type four vortex veins (complete systems including ampulla) and anastomotic branches of the vortex veins were significantly increased in elderly participants over 50 years of age (P < 0.05). Subfoveal choroidal thickness was significantly correlated with age, NVVR, CVVD and MRAVV (P < 0.05). This is the first study to reveal age-related alterations in vortex veins on ICGA in a healthy population. Aging may lead to partial vortex occlusion and residual vortex dilation. As age increases, anastomotic branches increasingly appear between the originally independent vortex veins. Translational relevance: Aging may lead to partial vortex occlusion and residual vortex dilation.

Case report: A Chinese patient with glutathione synthetase deficiency and a novel glutathione synthase mutation.

Glutathione synthetase deficiency (GSSD) is an autosomal-recessive metabolic disorder caused by glutathione synthetase (GSS) gene mutations. No more than 90 cases of GSSD have been reported worldwide; thus, the spectrum of GSS mutations and the genotype-phenotype association remain unclear. Here, we present a severely affected infant carrying a compound heterozygous GSS variation, c.491G > A, and a novel variant of c.1343_1348delTACTTC. We also summarize the clinical manifestations, treatment protocol, prognosis, and genetic characteristics of previously reported GSSD cases in China. In this case study, our patient presented with tachypnea, jaundice, intractable metabolic acidosis, and hemolytic anemia. Urinary-organic acid analysis revealed elevated 5-oxoproline levels. Further, this patient showed improved outcomes owing to early diagnosis and the timely administration of vitamins C and E. Therefore, our study indicates that in clinical cases of unexplained hemolytic anemia and metabolic acidosis, GSSD should be considered. Additionally, genetic testing and antioxidant application might help identify GSSD and improve the prognosis.

Si-Ni-San alleviates early life stress-induced depression-like behaviors in adolescence via modulating Rac1 activity and associated spine plasticity in the nucleus accumbens.

Background: Early life stress (ELS) is a major risk factor for depression in adolescents. The nucleus accumbens (NAc) is a key center of the reward system, and spine remodeling in the NAc contributes to the development of depression. The Si-Ni-San formula (SNS) is a fundamental prescription for treating depression in traditional Chinese medicine. However, little is known about the effects of SNS on behavioral abnormalities and spine plasticity in the NAc induced by ELS. Purpose: This study aimed to investigate the therapeutic effect and the modulatory mechanism of SNS on abnormal behaviors and spine plasticity in the NAc caused by ELS. Methods: We utilized a model of ELS that involved maternal separation with early weaning to explore the protective effects of SNS on adolescent depression. Depressive-like behaviors were evaluated by the sucrose preference test, the tail suspension test, and the forced swimming test; anxiety-like behaviors were monitored by the open field test and the elevated plus maze. A laser scanning confocal microscope was used to analyze dendritic spine remodeling in the NAc. The activity of Rac1 was detected by pull-down and Western blot tests. Viral-mediated gene transfer of Rac1 was used to investigate its role in ELS-induced depression-like behaviors in adolescence. Results: ELS induced depression-like behaviors but not anxiety-like behaviors in adolescent mice, accompanied by an increase in stubby spine density, a decrease in mushroom spine density, and decreased Rac1 activity in the NAc. Overexpression of constitutively active Rac1 in the NAc reversed depression-related behaviors, leading to a decrease in stubby spine density and an increase in mushroom spine density. Moreover, SNS attenuated depression-like behavior in adolescent mice and counteracted the spine abnormalities in the NAc induced by ELS. Additionally, SNS increased NAc Rac1 activity, and the inhibition of Rac1 activity weakened the antidepressant effect of SNS. Conclusion: These results suggest that SNS may exert its antidepressant effects by modulating Rac1 activity and associated spine plasticity in the NAc.

The Value of Targeting CXCR4 With 68Ga-Pentixafor PET/CT for Subtyping Primary Aldosteronism.

CONTEXT: Primary aldosteronism (PA) is one of the leading causes of secondary hypertension, and its diagnostic subtyping consistently presents a clinical challenge. OBJECTIVE: This study aimed to investigate the potential of 68Ga-Pentixafor positron emission tomography/computed tomography (PET/CT) in PA classification and its applicability in guiding the development of clinical treatment plans by increasing the sample size. METHODS: We prospectively enrolled 120 patients with either PA or nonfunctional adenoma (NFA) for analysis. All patients underwent 68Ga-Pentixafor PET/CT. Of these, 11 patients underwent adrenal venous sampling (AVS), 77 underwent adrenalectomy, 76 received pathological diagnoses, and 71 underwent immunohistochemical detection of aldosterone synthase (CYP11B2). Immunohistochemistry for C-X-C chemokine receptor 4 (CXCR4) was performed in 62 cases. Follow-up was conducted for all patients. RESULTS: Among the 120 patients, 66 were diagnosed with aldosterone-producing adenoma (APA), 33 with idiopathic hyperaldosteronism (IHA), and 21 with NFA. For APA patients, the sensitivity, specificity, and accuracy of visual analysis using 68Ga-Pentixafor PET/CT were 92.40%, 94.40%, and 93.33%, respectively. Furthermore, for APA patients with a nodule greater than 1 cm in diameter, when the maximum standard uptake value was 7.3 or greater, the specificity was 100%; and for APA patients with a nodule less than 1 cm in diameter, 68Ga-Pentixafor PET/CT also exhibited high sensitivity. AVS was successfully performed in 5 patients. Among the 5 patients, the concordance rate between the AVS and 68Ga-Pentixafor PET/CT for PA subtyping was 60%. In the 77 patients who underwent adrenalectomy, 61 PET/CT scans displayed positive lesions, all of which benefited from the surgery. Additionally, the concordance rate between 68Ga-Pentixafor PET/CT imaging and CYP11B2 was 81.69%. CONCLUSION: 68Ga-Pentixafor PET/CT is a reliable and noninvasive functional imaging technique that demonstrates high accuracy in classifying PA and provides valuable guidance for clinical treatment decision-making.