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Use This to Confirm Indeterminate Adrenal Lesions
Clin Endocrinol (Oxf); ePub 2017 Sep 5; Delivanis, et al
Given its superior specificity, 18FDG-PET/CT may serve as suitable second stage imaging for indeterminate adrenal lesions, researchers concluded after conducting a retrospective cohort study involving 353 individuals. Participants with adrenal nodules underwent biopsy and/or adrenalectomy between 1994 and 2014. Investigators looked at their imaging studies and found that:
- 80% of patients had known/suspected extra-adrenal malignancy.
- Among patients in whom abdominal CT was performed (n=353), median adrenal lesion size was 3 cm; median radiodensity was 33 Hounsfield units (HU).
- Radiodensity of >10 HU diagnosed malignancy with 100% sensitivity, 33% specificity, 72% positive predictive value (PPV), and 100% negative predictive value (NPV).
- Among patients in whom 18FDG-PET/CT was performed (n=89), maximum standardized uptake (SUV max) was 10 in malignant lesions, vs 3.7 in benign lesions.
- Median SUV max lesion to SUV max liver ratio (ALR) was 3 in malignant lesions, vs 1.2 in benign lesions.
- 18FDG-PET/CT ALR >1.8 diagnosed malignancy with 87% sensitivity, 84% specificity, 85% PPV, and 86% NPV.
Citation:
Delivanis D, Bancos I, Atwell T, et al. Diagnostic performance of unenhanced computed tomography and 18 F-fluorodeoxyglucose positron emission tomography in indeterminate adrenal tumours. [Published online ahead of print September 5, 2017]. Clin Endocrinol (Oxf). doi:10.1111/cen.13448.