Evaluation of adrenal masses in patients with bronchogenic carcinoma using 18F-fluorodeoxyglucose positron emission tomography.

Erasmus, Jeremy J.; Patz, Edward F.; McAdams, H. Page; Murray, John; Herndon, James E.; Coleman, R. Edward; Goodman, Philip C.

doi:10.2214/ajr.168.5.9129444

Cited by 298 publications

(98 citation statements)

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“…This approach is supported elsewhere [16,32] but it should be noted that MRI can provide additional information via chemical or phase shift-imaging regarding the possibility of benignity in such adrenal masses [126,127]. PET may also have a role to play and has been shown to have a sensitivity of 100% and a specificity of 80% in the detection of metastatic adrenal infiltration in a study of patients presenting with bronchogenic carcinoma and an adrenal mass [128].…”

Section: Metastatic Statusmentioning

confidence: 72%

Diagnostic imaging of lung cancer

Hollings¹,

Shaw²

2002

Eur Respir J

119

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Carcinoma of the bronchus is the most common malignancy in the Western world. It is also the leading cause of cancer-related death accounting for 32% of all cancer deaths in males and 25% in females [1]. In the USA it causes more deaths than cancers of the colon, breast and prostate combined [2]. Disappointingly, in a recent UK survey of improvements in cancer survival [3], carcinoma of the bronchus showed the smallest percentage reduction in the number of deaths avoided between 1981-1990 (0.2%). This compares badly with breast (11% reduction) and melanoma (32%). The overall 5-yr survival for lung cancer diagnosed between 1986-1990 was only 5.3% (against 66% for breast and 76% for melanoma). It is on this background that the radiologist remains actively employed in the detection, diagnosis, staging and review of this common malignancy.

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Section: Metastatic Statusmentioning

confidence: 72%

Diagnostic imaging of lung cancer

Hollings¹,

Shaw²

2002

Eur Respir J

119

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“…Of the 104 articles identified, 24 contained clinical information dealing with metastasis to the adrenal gland while 80 used PET nonspecifically or specifically to other organs (thorax, mediastinum, brain, liver, etc). Of these 24 studies, 8 were identified to contain reportable pertinent oncologic information, including at least 50% of the study population with NSCLC and concomitant adrenal lesions evaluated by FDG-PET/CT [6][7][8][9][10][11][12] or FDG-PET. 13 The FDG-PET only study was excluded because PET-only literature is considered obsolete compared with PET/CT.…”

Section: Literature Review Methods and Resultsmentioning

confidence: 99%

Fluorodeoxyglucose-Positron-Emission Tomography/Computed Tomography Imaging for Adrenal Masses in Patients with Lung Cancer: Review and Diagnostic Algorithm

Stone

Wymer

Canales

2014

Journal of Endourology

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Background and Purpose: Positron-emission tomography/computed tomography (PET/CT) with fluorine-18 fluorodeoxyglucose (FDG) is used as first-line staging for patients with newly diagnosed non-small cell lung cancer (NSCLC). Our purpose was to review the accuracy of FDG-PET/CT to predict adrenal gland metastasis, explain the causes for false-positive PET, and provide a diagnostic algorithm. Patients and Methods: Two patients with incidentally discovered lung masses were found to have hypermetabolic adrenal activity by FDG-PET/CT with maximal standard uptake value (SUV) of 4.5 and 6.5. A MEDLINE search was performed on the topic of FDG-PET/CT, adrenal gland metastasis, and NSCLC. Literature was reviewed with regard to diagnosis, accuracy, outcomes, and alternative imaging or diagnostic strategies. Results: Both patients underwent transabdominal laparoscopic adrenalectomy and were found to have nodular hyperplasia without evidence of adrenal tumor. A total of seven articles containing 343 patients were identified as having pertinent oncologic information for NSCLC patients with adrenal lesions. Sensitivity and specificity of PET/CT for distant metastasis was 94% and 85%, respectively, but only 13% (44/343) of these patients had histologically confirmed adrenal diagnoses. Based on this, a diagnostic algorithm was created to aid in decision making. Conclusions: Although PET/CT has high sensitivity and specificity for adrenal metastasis in the setting of NSCLC, adrenal biopsy or other secondary imaging should be considered to confirm the finding. Adrenalectomy in lieu of biopsy may have both diagnostic and therapeutic benefit in cases where the adrenal mass is ‡ 10 mm with high PET maximum SUV ( ‡ 3.1) and SUV ratios ( > 2.5), where washout CT or chemical shift MRI is positive, or where percutaneous biopsy is deemed too difficult or unsafe.

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“…As far as the adrenal is concerned, most of the studies reported have dealt with the potential role of FDG-PET in the staging of patients with known extra-adrenal cancers (8,83,84). It has been well documented that FDG-PET provides a greater sensitivity than traditional radiologic imaging (8,72,80,(82)(83)(84)(85).…”

Section: Clinical Applications Of Fdg-petmentioning

confidence: 99%

Functional scintigraphy of the adrenal gland

et al. 2002

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Over the last 30 years nuclear medicine imaging of the adrenal gland and its lesions has been achieved by the exploitation of a number of physiological characteristics of this organ. By seeking and utilising features which are quantitatively or qualitatively different from those of the adjacent tissues, functional depiction of the adrenal gland and its diseases, which in most cases retain the basic physiology of their tissue of origin, including both the cortex and the medulla, are now a useful clinical reality. Agents widely used in clinical practice include: (a) uptake and storage of radiolabelled cholesterol analogues via the low density lipoprotein (LDL) receptor and cholesterol ester storage pool in the adrenal cortex ( 131 I-6-b-iodomethyl-norcholesterol, 75 Se-selenomethyl-norcholesterol); (b) catecholamine type I, presynaptic, uptake mechanism and intracellular granule uptake and storage mechanism in the adrenal medulla and extra-adrenal paraganglia ( 131 I-, 123 I-and 124 Imeta-iodo-benzyl-guanidine (MIBG), 18 F-metafluoro-benzyl-guanidine); (c) cell surface receptor binding of peptides/neurotransmitters/modulators such as for the family of five subtypes of somatostatin receptors ( 123 I-tyr-octreotide, 111 In-DTPA-octreotide, 111 In-DOTA-octreotide and many others); (d) although not specific for the adrenal gland, increased glycolysis by tumours, particularly the most malignant varieties, 18 F-2-fluoro-D-deoxyglucose can thus be expected to depict certain malignant lesions such as malignant pheochromocytomas (particularly the minority which are not detected by MIBG) and adrenal incidentalomas (particularly when they occur in patients with known extraadrenal malignancies). There are a variety of adrenal tissue characteristics with potential for exploitation but which are not currently in clinical use, and which may, nevertheless, have potential as imaging agents. These include: (a) inhibitors of adrenal cortical steroid hormone synthesis enzymes (e.g. radiolabelled analogues of metyrapone); (b) radiolabelled lipoproteins which bind to adrenocortical LDL receptors; (c) inhibitors of catecholamine biosynthesis enzymes (e.g. radiolabelled analogues of tyrosine and related amino acids); (d) cell surface receptors for various peptides and hormones which may be overexpressed on adrenal cortical or adrenal medullary tumours (e.g. radiolabelled analogues of ACTH on adrenocortical cells of zona fasciculata or zona glomerulosa origin, neurotransmitter/hormone message peptides binding to cell surface receptors such as bombesin, vasoactive intestinal polypeptide, cholecystokinin and opiate peptides); (e) the adrenal cortex can also synthesise cholesterol ab initio from acetate, and preliminary studies with 11 C-acetate positron emission tomography have shown interesting results. European Journal of Endocrinology 147 13-28 Adrenal cortexThe adrenal cortex is constituted of three layers. The outer layer, the glomerulosa zone, produces mineralocorticoids (mainly aldosterone) under the control of the renin -a...

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Evaluation of adrenal masses in patients with bronchogenic carcinoma using 18F-fluorodeoxyglucose positron emission tomography.

Cited by 298 publications

References 0 publications

Diagnostic imaging of lung cancer

Diagnostic imaging of lung cancer

Fluorodeoxyglucose-Positron-Emission Tomography/Computed Tomography Imaging for Adrenal Masses in Patients with Lung Cancer: Review and Diagnostic Algorithm

Functional scintigraphy of the adrenal gland

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