Performance of 18F-FDG PET/CT in the characterization of adrenal masses in non-cancer patients: A prospective study.

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Performance of 18F-FDG PET/CT in the characterization of adrenal masses in non-cancer patients: A prospective study.

J Clin Endocrinol Metab. 2017 Apr 20;:

Authors: Guerin C, Pattou F, Brunaud L, Lifante JC, Mirallié E, Haissaguerre M, Huglo D, Olivier P, Houzard C, Ansquer C, Hindié E, Loundou A, Archange C, Tabarin A, Sebag F, Baumstarck K, Taïeb D

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 non-cancer 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-ACC) and 72 as benign. Compared to 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.

PMID: 28431167 [PubMed - as supplied by publisher]

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