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- Title
18F-FDG-PET/CT Evaluation of Indeterminate Adrenal Masses in Noncancer Patients.
- Authors
Xin He; Caoili, Elaine M.; Avram, Anca M.; Miller, Barbra S.; Else, Tobias; He, Xin
- Abstract
<bold>Context: </bold>Adrenal tumors in noncancer patients are common.<bold>Objective: </bold>Evaluate performance of 18F-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) in distinguishing between benign and malignant adrenal tumors.<bold>Design: </bold>Retrospective chart review 2010-2019.<bold>Setting: </bold>Academic institution.<bold>Patients: </bold>One hundred and seventeen noncancer patients, defined as having no history of cancer or with cancer in remission for ≥5 years, completed 18F-FDG-PET/CT to evaluate adrenal masses, with pathologic diagnoses or imaging follow-up (≥12 months).<bold>Intervention: </bold>18F-FDG-PET/CT of 117 indeterminate adrenal masses.<bold>Main Outcome Measures: </bold>Receiver operator characteristic curve of the ratios of adrenal lesion standardized uptake value (SUV)max to liver SUVmean and of adrenal lesion SUVmax to aortic arch blood pool SUVmean were constructed.<bold>Results: </bold>Seventy benign and 47 malignant masses (35 adrenocortical carcinomas [ACCs], 12 adrenal metastases) were identified. Malignant masses had higher median liver SUV and blood pool SUV ratios than benign masses (6.2 and 7.4 vs 1.4 and 2.0, P < .001). Median liver and blood pool SUV ratios of ACC (6.1 and 7.3, respectively) and metastases (6.7 and 7.7, respectively) were higher than those of than adenomas (1.4 and 2.2, P < .05 for all comparisons). Optimal liver SUV ratio to discern between benign and malignant masses was 2.5, yielding 85% sensitivity, 90% specificity, and 7 false negative results (including 3 ACCs). Optimal blood pool SUV ratio was 3.4, yielding 83% sensitivity, 90% specificity, and 8 false negative results (including 4 ACCs).<bold>Conclusion: </bold>When used in conjunction with other clinical assessments, 18F-FDG-PET/CT can be a valuable tool in evaluating adrenal masses in noncancer patients.
- Subjects
MAGNETIC resonance imaging; MEDICAL research; PHYSICIANS; ANAPLASTIC lymphoma kinase; POSITRON emission tomography computed tomography; COMPUTED tomography
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 5, p1448
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgab005