Carole Guerin1, François Pattou2, Laurent Brunaud3, Jean-Christophe Lifante4, Eric Mirallié5, Magalie Haissaguerre6, Damien Huglo7, Pierre Olivier8, Claire Houzard9, Catherine Ansquer10, Elif Hindié11, Anderson Loundou12, Cendrine Archange13, Antoine Tabarin6, Fréderic Sebag1, Karine Baumstarck12, David Taïeb13. 1. Service de Chirurgie Générale et Endocrinienne, Centre Hospitalier Conception, APHM, Aix Marseille Univ, 13005 Marseille, France. 2. Service de Chirurgie Endocrinienne, Centre Hospitalier Régional Universitaire de Lille, 59037 Lille, France; Université Lille Nord de France, INSERM, Lille, France. 3. Université de Lorraine, Service de Chirurgie Digestive, Hépatobiliaire et Endocrinienne, Centre Hospitalo-Universitaire Nancy Brabois, 54511 Nancy, France. 4. Service de Chirurgie Générale et Endocrinienne, Centre Hospitalier Lyon Sud, Pierre Bénite, 69495 Lyon, France. 5. Clinique de Chirurgie Digestive et Endocrinienne, Hôtel Dieu, CHU Nantes, 44000 Nantes, France. 6. Service d'Endocrinologie, Diabétologie et Nutrition, Centre Hospitalo-Universitaire de Bordeaux, Hôpital Haut-Lévêque Pessac, 33600 Pessac, France. 7. Service de Médecine Nucléaire, Centre Hospitalo-Universitaire de Lille, OncoTHAI, INSERM U 1189, Univ, 59037 Lille, France. 8. Service de Médecine Nucléaire, Centre Hospitalo-Universitaire Nancy Brabois, 54511 Nancy, France. 9. Service de Médecine Nucléaire, Centre Hospitalier Lyon Sud, Pierre-Bénite, 69495 Lyon, France. 10. Service de Médecine Nucléaire, Hôtel Dieu, CHU Nantes, 44000 Nantes, France. 11. Service de Médecine Nucléaire, Centre Hospitalo-Universitaire de Bordeaux, Hôpital Haut-Lévêque Pessac, 33600 Pessac, France. 12. Service de Santé Publique, Faculté de Médecine de la Timone, Aix Marseille Univ, 13005 Marseille, France. 13. Service de Médecine Nucléaire, Centre Hospitalo-Universitaire de la Timone, APHM, Centre Européen de Recherche en Imagerie Médicale, Aix Marseille Univ, 13385 Marseille, France.
Abstract
Context: Few prospective studies have evaluated the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the characterization of adrenal masses. Objective: To assess the performance of 18F-FDG PET/CT in the malignancy diagnosis of adrenal masses in noncancer patients. Design: Prospective multicenter study. Material and Methods: The study population consisted of 87 patients (87 adrenal masses) referred to endocrine surgeons: 56 with mass diameter ≥40 mm and 31 with a diameter <40 mm and of indeterminate nature based on unenhanced and washout CT attenuation densities. Fourteen patients had hypercortisolism. Adrenal masses were characterized by 18F-FDG PET/CT. Histology was the gold standard for the diagnosis of malignancy. In the absence of pathological proof (n = 23), the nature of the lesion was based on the 12-month imaging follow-up. Results: Fifteen adrenal masses were classified as malignant (including 11 adrenocortical carcinomas) and 72 as benign. Compared with benign lesions, malignant lesions were larger in size (P = 0.003), had higher unenhanced densities (P = 0.002), lower relative washout values (P = 0.007), and higher 18F-FDG uptake parameters (P < 10-3). The optimal threshold value of (Tumor SUVmax:Liver SUVmax) the ratio for malignancy was >1.5 with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 86.7%, 86.1%, 56.5%, 96.9%, and 86.2%, respectively. Conclusions: Our results show that 18F-FDG PET/CT complements adrenal washout CT in the evaluation of adrenal masses and should be recommended in the evaluation of large and/or indeterminate adrenal masses.
Context: Few prospective studies have evaluated the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the characterization of adrenal masses. Objective: To assess the performance of 18F-FDG PET/CT in the malignancy diagnosis of adrenal masses in noncancer patients. Design: Prospective multicenter study. Material and Methods: The study population consisted of 87 patients (87 adrenal masses) referred to endocrine surgeons: 56 with mass diameter ≥40 mm and 31 with a diameter <40 mm and of indeterminate nature based on unenhanced and washout CT attenuation densities. Fourteen patients had hypercortisolism. Adrenal masses were characterized by 18F-FDG PET/CT. Histology was the gold standard for the diagnosis of malignancy. In the absence of pathological proof (n = 23), the nature of the lesion was based on the 12-month imaging follow-up. Results: Fifteen adrenal masses were classified as malignant (including 11 adrenocortical carcinomas) and 72 as benign. Compared with benign lesions, malignant lesions were larger in size (P = 0.003), had higher unenhanced densities (P = 0.002), lower relative washout values (P = 0.007), and higher 18F-FDG uptake parameters (P < 10-3). The optimal threshold value of (Tumor SUVmax:Liver SUVmax) the ratio for malignancy was >1.5 with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 86.7%, 86.1%, 56.5%, 96.9%, and 86.2%, respectively. Conclusions: Our results show that 18F-FDG PET/CT complements adrenal washout CT in the evaluation of adrenal masses and should be recommended in the evaluation of large and/or indeterminate adrenal masses.
Authors: David Taïeb; Rodney J Hicks; Elif Hindié; Benjamin A Guillet; Anca Avram; Pietro Ghedini; Henri J Timmers; Aaron T Scott; Saeed Elojeimy; Domenico Rubello; Irène J Virgolini; Stefano Fanti; Sona Balogova; Neeta Pandit-Taskar; Karel Pacak Journal: Eur J Nucl Med Mol Imaging Date: 2019-06-29 Impact factor: 9.236
Authors: Giuseppina Incampo; Luigi Di Filippo; Erika Maria Grossrubatscher; Paolo Dalino Ciaramella; Stefano Frara; Andrea Giustina; Paola Loli Journal: Endocrine Date: 2022-02-12 Impact factor: 3.633