Usefulness of F-18 FDG PET/CT in Adrenal Incidentaloma: Differential Diagnosis of Adrenal Metastasis in Oncologic Patients.
- Author:
Hong Je LEE
1
;
Bong Il SONG
;
Sung Min KANG
;
Shin Young JEONG
;
Ji Hyoung SEO
;
Sang Woo LEE
;
Jeongsoo YOO
;
Byeong Cheol AHN
;
Jaetae LEE
Author Information
1. Department of Nuclear Medicine, Kyungpook National University School of Medicine, Daegu, Korea. jaetae@knu.ac.kr
- Publication Type:Original Article
- Keywords:
Adrenal incidentaloma;
F-18 FDG PET/CT;
SUVratio;
small adrenal mass
- MeSH:
Adrenal Gland Neoplasms;
Diagnosis, Differential;
Humans;
Male;
Neoplasm Metastasis;
Sensitivity and Specificity
- From:Nuclear Medicine and Molecular Imaging
2009;43(5):421-428
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We have evaluated characteristics of adrenal masses incidentally observed in nonenhanced F-18 FDG PET/CT of the oncologic patients and the diagnostic ability of F-18 FDG PET/CT to differentiate malignant from benign adrenal masses. MATERIALS AND METHODS: Between Mar 2005 and Aug 2008, 75 oncologic patients (46 men, 29 women; mean age, 60.8+/-10.2 years; range, 35-87 years) with 89 adrenal masses incidentally found in PET/CT were enrolled in this study. For quantitative analysis, size (cm), Hounsfield unit (HU), maximum standardized uptake value (SUVmax), SUVratio of all 89 adrenal masses were measured. SUVmax of the adrenal mass divided by SUVliver, which is SUVmax of the segment 8, was defined as SUVratio. The final diagnosis of adrenal masses was based on pathologic confirmation, radiologic evaluation (HU<0 : benign), and clinical decision. RESULTS: Size, HU, SUVmax, and SUVratio were all significantly different between benign and malignant adrenal masses.(P < 0.05) And, SUVratio was the most accurate parameter. A cut-off value of 1.0 for SUVratio provided 90.9% sensitivity and 75.6% specificity. In small adrenal masses (1.5 cm or less), only SUVratio had statistically significant difference between benign and malignant adrenal masses. Similarly a cut-off value of 1.0 for SUVratio provided 80.0% sensitivity and 86.4% specificity. CONCLUSION: F-18 FDG PET/CT can offer more accurate information with quantitative analysis in differentiating malignant from benign adrenal masses incidentally observed in oncologic patients, compared to nonenhanced CT.
