Imaging of Adrenal Masses with Emphasis on Adrenocortical Tumors
- 1 January 2012
- journal article
- Published by Ivyspring International Publisher in Theranostics
- Vol. 2 (5), 516-522
- https://doi.org/10.7150/thno.3613
Abstract
Because of the more widespread and frequent use of cross-sectional techniques, mainly computed tomography (CT), an increasing number of adrenal tumors are detected as incidental findings (“incidentalomas”). These incidentaloma patients are much more frequent than those undergoing imaging because of symptoms related to adrenal disease. CT and magnetic resonance imaging (MRI) are in most patients sufficient for characterization and follow-up of the incidentaloma. In a minor portion of patients, biochemical screening reveals a functional tumor and further diagnostic work-up and therapy need to be performed according to the type of hormonal overproduction. In oncological patients, especially when the morphological imaging criteria indicate an adrenal metastasis, biopsy of the lesion should be considered after pheochromocytoma is ruled out biochemically. In the minority of patients in whom CT and MRI fail to characterize the tumor and when time is of essence, functional imaging mainly by positron emission tomography (PET) is available using various tracers. The most used PET tracer, [18F]fluoro-deoxy-glucose (18FDG), is able to differentiate benign from malignant adrenal tumors in many patients. 11C-metomidate (11C-MTO) is a more specialized PET tracer that binds to the 11-beta-hydroxylase enzyme in the adrenal cortex and thus makes it possible to differ adrenal tumors (benign adrenocortical adenoma and adrenocortical cancer) from those of non-adrenocortical origin.Keywords
This publication has 37 references indexed in Scilit:
- The role of fluorodeoxyglucose-positron emission tomography/computed tomography in differentiating between benign and malignant adrenal lesionsNuclear Medicine Communications, 2011
- Comparison of 18F-Fluoro-L-DOPA, 18F-Fluoro-Deoxyglucose, and 18F-Fluorodopamine PET and 123I-MIBG Scintigraphy in the Localization of Pheochromocytoma and ParagangliomaJournal of Clinical Endocrinology & Metabolism, 2009
- Masked volume wise principal component analysis of small adrenocortical tumours in dynamic [11C]-metomidate positron emission tomographyBMC Medical Imaging, 2009
- PET/CT for the Characterization of Adrenal Masses in Patients with Cancer: Qualitative Versus Quantitative Accuracy in 150 Consecutive PatientsAmerican Journal of Roentgenology, 2009
- Computed tomography, magnetic resonance imaging and 11C-metomidate positron emission tomography for evaluation of adrenal incidentalomasEuropean Journal of Radiology, 2009
- Utility of PET/CT in Differentiating Benign from Malignant Adrenal Nodules in Patients with CancerAmerican Journal of Roentgenology, 2008
- Preoperative evaluation of adrenal lesions based on imaging studies and laparoscopic adrenalectomy in patients with otherwise operable lung cancerLung Cancer, 2007
- Differentiating Adrenal Adenomas From Nonadenomas Using 18F-FDG PET/CT: Quantitative and Qualitative EvaluationAcademic Radiology, 2007
- Analysis of adrenal masses by 18F-FDG positron emission tomography scanningInternational Journal of Clinical Practice, 2007
- Imaging of adrenal tumors using FDG PET: comparison of benign and malignant lesions.American Journal of Roentgenology, 1999