Adrenal Imaging

Blake, Michael A.; Cronin, Carmel G.; Boland, Giles W.

doi:10.2214/ajr.10.4547

Cited by 228 publications

(172 citation statements)

References 72 publications

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“…On the other hand, about 30% of cortical adenomas have low lipid content and exhibit high attenuation values. Nevertheless, it has been reported that mass density of %10 HU had the best combined sensitivity and specificity to differentiate benign from malignant tumors (7,16,17).…”

Section: Discussionmentioning

confidence: 99%

The clinical course of patients with adrenal incidentaloma: is it time to reconsider the current recommendations?

Kaštelan

Kraljević

Dušek

et al. 2015

European Journal of Endocrinology

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Objective: The current guidelines for the management of adrenal incidentaloma advise hormonal and radiological follow-up of patients for 2-5 years after the initial diagnosis. However, the vast majority of adrenal incidentaloma are non-functional benign cortical adenomas that require no treatment, so the routine application of the current strategies often results in a number of unnecessary biochemical and radiological investigations. The aim of this study was to analyse the clinical course of patients with adrenal incidentaloma and to provide a critical review of the current management strategy of the disease. Design and methods: This was a retrospective study performed in the Croatian Referral Center for adrenal gland disorders. The study included 319 consecutive patients with adrenal incidentaloma, 174 of which were followed for at least 24 months. Results: The vast majority of patients were diagnosed with benign adrenal masses, whereas in about 5% of them adrenal tumor corresponded to adrenal carcinoma or metastasis. Tumor density was found to be superior to tumor size in distinguishing benign adrenal masses from malignant tumors and pheochromocytomas. During the follow-up, no patient demonstrated a clinically significant increase in tumor size. In addition, no changes, either in metanephrines and normetanephrines or in the activity of renin-aldosterone axis, were observed during the follow-up. Six patients developed subclinical Cushing's syndrome (SCS) whereas eight patients with SCS showed biochemical remission during follow-up. Conclusion: The study suggests that the risk of an adrenal mass initially diagnosed as benign and non-functional becoming malignant or hormonally active is extremely low. Therefore, the clinical management of those patients should be tailored on an individual basis in order to avoid unnecessary procedures.

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Section: Discussionmentioning

confidence: 99%

The clinical course of patients with adrenal incidentaloma: is it time to reconsider the current recommendations?

Kaštelan

Kraljević

Dušek

et al. 2015

European Journal of Endocrinology

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“…12 Adrenal metastases should be morphologically differentiated from non-functioning adrenal adenomas that are incidentally discovered in up to 5% of abdominal CT examinations in adult patients without malignancy, 2,3 and even more often in patients with a known malignancy. 13 In patients with a primary extraadrenal neoplasm and no other evidence of distant metastatic disease, characterization of the lesion using noninvasive imaging can reduce the necessity for percutaneous adrenal mass biopsy in most patients. 14 Characterization of lipid-rich adenomas is straightforward using both unenhanced CT and MRI, and represented with attenuation values of ≤10 HU on CT, and obvious signal drop on opposed-phase MRI.…”

Section: Discussionmentioning

confidence: 99%

“…14 Characterization of lipid-rich adenomas is straightforward using both unenhanced CT and MRI, and represented with attenuation values of ≤10 HU on CT, and obvious signal drop on opposed-phase MRI. 13 Unfortunately, about 29% of adenomas have attenuation values higher than 10 HU and remain indeterminate on unenhanced CT scan. 15 They could be distinguished from other pathology on contrast-enhanced CT with quantification of contrast material washout, but the radiologist should be available during examination in order to decide whether additional contrast-enhanced scanning is needed.…”

Section: Discussionmentioning

confidence: 99%

Should we use CT or MRI for detection and characterization of benign adrenal lesions?

Paar

Đido

Štern-Padovan

2015

Annales d'Endocrinologie

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“…7a). A significant exception are metastases of malignancies in which the primary tumour does not accumulate this radiopharmaceutical 51 .…”

Section: Finding On Imaging Studiesmentioning

confidence: 99%

Adrenal disease: a clinical update and overview of imaging. A review

Čtvrtlík¹,

Koranda²,

Tichý³

2014

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aim. The aim of this article is to provide an overview of the most frequent clinically significant adrenal diseases and to describe the latest trends in their diagnostics, particularly by means of imaging techniques. Methods. The authors reviewed standard textbooks and subsequently conducted a search using the PubMed (Public/ Publisher MEDLINE) electronic database by the year 2013 with the following search terms: adrenal masses, adrenal adenoma, phaeochromocytoma, adrenocortical carcinoma, metastases, incidentalomas, hypercortisolism, hyperaldosteronism. Results. If adrenal disease is clinically suspected, hormone tests are performed to detect adrenal hyperfunction and imaging studies are used to assess the nature of adrenal lesion. The most frequent syndromes include hypercortisolism, primary hyperaldosteronism, and phaeochromocytoma. The clinically most significant pathologies of the adrenal glands are adenomas and adrenal hyperplasia, adrenocortical carcinomas, phaeochromocytomas, and metastases. Given the availability and improved quality of imaging techniques, adrenal incidentalomas are detected increasingly often. In these cases, it is necessary to rule out hormonal activity and malignancy. Incidentalomas can be associated with clinical syndromes of adrenal hormone overproduction. In most cases, they are clinically silent. In some cases, the definitive diagnosis can be determined as early as during the initial examination with an imaging technique (most frequently, a CT scan). If the finding is inconsistent, other imaging techniques can be used: CT contrast washout analysis, MRI, SPECT or PET/CT. Conclusion. In the case of adrenal gland disorders, correct interpretation of the results of laboratory tests and imaging studies is essential for further management of these patients.

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Adrenal Imaging

Abstract: The imaging characterization of adrenal lesions has continued to advance over the past decade as new technologies have evolved. CT, MRI, PET, and PET/CT are now established clinical techniques capable of differentiating benign from malignant adrenal lesions.

Cited by 228 publications

References 72 publications

The clinical course of patients with adrenal incidentaloma: is it time to reconsider the current recommendations?

The clinical course of patients with adrenal incidentaloma: is it time to reconsider the current recommendations?

Should we use CT or MRI for detection and characterization of benign adrenal lesions?

Adrenal disease: a clinical update and overview of imaging. A review

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