C-X-C motif chemokine receptor 4 (CXCR4)–directed imaging has gained clinical interest in aiding clinical diagnostics in primary aldosteronism (PA). We retrospectively evaluated the feasibility of CXCR4-directed scintigraphy using the novel CXCR-4 ligand [^99mTc]Tc-pentixatec in patients with PA. Methods: Six patients (mean age ± SD, 49 ± 15 y) underwent CXCR4-directed scintigraphy (including planar imaging and SPECT/CT) 30, 120, and 240 min after injection of 435 ± 50 MBq of [^99mTc]Tc-pentixatec. Adrenal CXCR4 expression was analyzed by calculating lesion-to-contralateral ratios (LCRs). Imaging results were correlated to clinical information. Histopathology and clinical follow-up served as the standard of reference. Results: Three subjects showed lateralization of adrenal tracer accumulation, with a mean maximum lesion-to-contralateral ratio of 1.65 (range, 1.52–1.70), which correlated with morphologic findings on CT. One individual underwent adrenalectomy and presented with complete biochemical and clinical remission at follow-up. Histopathologic workup confirmed unilateral aldosterone-producing adenoma. Conclusion: [^99mTc]Tc-pentixatec scintigraphy with SPECT in patients with PA is feasible and might offer a valuable alternative to CXCR4-directed imaging with [⁶⁸Ga]Ga-pentixafor PET.

C-X-C 基序趋化因子受体 4 （CXCR4） 定向成像在辅助原发性醛固酮增多症 （PA） 的临床诊断方面引起了临床兴趣。我们回顾性评估了使用新型 CXCR-4 配体 [^99mTc]Tc-pentixatec 在 PA 患者中进行 CXCR4 定向闪烁显像的可行性。方法：6 例患者 （平均年龄 ± SD，49 ± 15 岁）在注射 435 ± 50 MBq 的 [^99mTc]Tc-Pentixatec 后 30 、 120 240 分钟接受了 CXCR4 定向闪烁显像 （包括平面成像和 SPECT/CT）。通过计算病变对侧比 （LCR） 来分析肾上腺 CXCR4 的表达。影像学结果与临床信息相关。组织病理学和临床随访作为参考标准。结果：3 名受试者表现出肾上腺示踪剂积累的偏侧化，平均最大病变与对侧比为 1.65（范围，1.52-1.70），这与 CT 上的形态学发现相关。1 例接受了肾上腺切除术，随访时生化和临床完全缓解。组织病理学检查证实为单侧醛固酮分泌腺瘤。结论：在 PA 患者中使用 SPECT 进行 [^99mTc]Tc-pentixatec 闪烁显像是可行的，并且可能为使用 [⁶⁸Ga]Ga-pentixafor PET 进行 CXCR4 定向成像提供有价值的替代方案。