18F-FDG Uptake in Benign Fibrous Histiocytoma of Adrenal Gland (original) (raw)
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Hellenic journal of nuclear medicine
To evaluate the diagnostic and prognostic role of fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in comparison to morphological imaging such as computed tomography in primary adrenal malignancies. In this multicenter retrospective study, 68 patients with adrenal malignancy were included. All patients had histologically proven diagnosis of primary adrenal malignancy (adrenocortical carcinoma, malignant pheochromocytoma, neuroblastoma and lymphoma), one whole body (18)F-FDG PET/CT scan and one whole-body contrast enhancement computed tomography (CECT) scan acquired within one month and were followed clinically and by performing morphological tests for at least 12 months. Overall sensitivity, specificity, accuracy, positive and negative predictive values for CECT and (18)F-FDG PET/CT were respectively, 59%, 100%, 65%, 100%, 27% and 75%, 100%, 82%, 100% and 63%. For adrenocortical carcinomas, (18)F-FDG PET/CT showed a better accu...
World Journal of Surgery, 2012
Background Adrenocortical carcinoma (ACC) is a rare cancer for which little level evidence exists to guide management. 18 F-FDG PET (18 F-fluorodeoxyglucose positron emission tomography) is an increasingly used diagnostic tool in patients with suspicious or indeterminate adrenal tumors. In some other solid tumors, 18 F-FDG PET may offer prognostic information that can guide optimal patient treatment. The aim of the present study was to evaluate whether preoperative 18 F-FDG PET based on SUVs assessments has a prognostic value in ACC patients. Methods A retrospective analysis was performed in patients who underwent 18 F-FDG PET/CT for the evaluation of ACC. Inclusion criteria were an unequivocal diagnosis of ACC; all data from primary diagnosis available; 18 F-FDG PET/CT performed prior to surgery or other treatment of the primary tumor; a minimum of 6-months follow-up for surviving patients. All 18 F-FDG PET/CT procedures were reinterpreted in a blind fashion. Results Thirty-seven patients (23 without metastasis [M0], 14 with metastasis [M1]) fulfilled the study criteria. Median uptake values were tumor standardized uptake values (SUV) max = 11 (range: 3-56) and a tumor/liver
European Journal of Nuclear Medicine and Molecular Imaging, 2008
Purpose The widespread use of high-resolution crosssectional imaging such as computed tomography (CT) and magnetic resonance imaging (MRI) for the investigation of the abdomen is associated with an increasing detection of incidental adrenal masses. We evaluated the ability of 18 F-fluorodeoxyglucose positron emission tomography to distinguish benign from malignant adrenal masses when CT or MRI results had been inconclusive. Methods We included only patients with no evidence of hormonal hypersecretion and no personal history of cancer or in whom previously diagnosed cancer was in prolonged remission. PET/CT scans were acquired after 90 min (mean, range 60-140 min) after FDG injection. The visual interpretation, maximum standardised uptake values (SUVmax) and adrenal compared to liver uptake ratio were correlated with the final histological diagnosis or clinico-radiological followup when surgery had not been performed. Results Thirty-seven patients with 41 adrenal masses were prospectively evaluated. The final diagnosis was 12 malignant, 17 benign tumours, and 12 tumours classified as benign on follow-up. The visual interpretation was more accurate than SUVmax alone, tumour diameter or unenhanced density, with a sensitivity of 100% (12/12), a specificity of 86% (25/ 29) and a negative predictive value of 100% (25/25). The use of 1.8 as the threshold for tumour/liver SUVmax ratio, retrospectively established, demonstrated 100% sensitivity and specificity. Conclusion FDG PET/CT accurately characterises adrenal tumours, with an excellent sensitivity and negative predictive values. Thus, a negative PET may predict a benign tumour that would potentially prevent the need for surgery of adrenal tumours with inconclusive conventional imaging.
18F-FDG PET/CT of a Rare Case of an Adenomatoid Tumor of the Adrenal Gland
Clinical Nuclear Medicine, 2020
A 28-year old man, with previous history of chronic abdominal pain, was referred to our nuclear medicine center for an 18 F-FDG PET/CT following the fortuitous discovery of a 48-mm right adrenal gland lesion of heterogeneous density at the CT scan. The PET/CT showed an isolated heterogeneous significant uptake evocative of neoplasia. Surprisingly, the anatomopathological analysis after surgery revealed an adenoid tumor of the adrenal gland. This case of a rare benign tumor can be a source of falsepositive and mimicking malignancies in the exploration of adrenal lesions.
European Journal of Nuclear Medicine and Molecular Imaging, 2010
Purpose This prospective multicentre study assesses the usefulness of FDG PET/CT in characterizing and making the therapeutic decision concerning adrenal tumours that are suspicious or indeterminate in nature after conventional examinations (CE). Methods Seventy-eight patients (37 men, 41 women, 81 adrenal lesions) underwent FDG PET/CT after CE including CT scan, biological tests and optionally 131 I-metaiodobenzylguanidine (MIBG) and/or 131 I-norcholesterol scans. FDG adrenal uptake exceeding that of the liver was considered positive. PET results were not decisive. Surgery was discussed when at least one of the following criteria was found during CE: size >3 cm, spontaneous attenuation value >10 HU, heterogeneous aspect, abnormal MIBG or norcholesterol scan or hormonal hypersecretion. Results Following the gold standard (histology analysis or ≥9 months follow-up), 49 lesions potentially qualified for surgery (malignant = 27, benign secreting = 22) and 32 benign non-secreting lesions did not. PET was negative in 97% of non-surgical lesions and positive in 73% of potentially surgical ones which included all the malignant lesions, except 3 renal cell metastases, and 12 of 22 benign secreting lesions. The negative predictive value for malignancy was 93% (41/44) and positive predictive value for detecting surgical lesions was 97% (36/37). A high FDG uptake (maximum standardized uptake value≥10) was highly predictive of malignancy. Conclusion Adrenal FDG uptake is a good indicator of malignancy and/or of secreting lesions and should lead one to discuss surgery. If there is no prior history of poorly FDG-avid cancer, the absence of FDG uptake should avoid unnecessary removal of benign adrenal lesions.
Asia Oceania Journal of Nuclear Medicine and Biology, 2018
F-18 FDG is the most widely used tracer in molecular imaging and it is applied for many purposes mainly in malignant diseases. Incidental finding are common in FDG-PET/CT imaging and includes benign and malignant lesions. Among the rare tumors, adrenal oncocytomas are uncommon findings and incidental findings of thyroid malignancies are not rare. Oncocytoma is a rare adrenocortical tumor and majority of bulky adrenal tumors are benign with uncertain incident of malignancy. In this study, we are reporting a 37-year-old man with two incidental malignancies detected by FDG-PET-CT. He has no symptoms has no blood and hormonal abnormalities. The scan demonstrated intense heterogeneous FDG uptake within the bulky oval shaped lesion in the left adrenal gland. Accordingly, open adrenalectomy was performed and diagnosis of adrenocortical carcinoma oncocytic type was established. Furthermore, a focal FDG uptake was identified in the right thyroid lobe and histopathology findings were consist...
Clinical Lung Cancer, 2001
This study was designed to evaluate the sensitivity, specificity, and predictive accuracy of PET-FDG imaging in detecting metastatic disease involvement of adrenal glands in patients with lung cancer. We wanted to compare efficacy of positron emission tomography (PET)-fluorodeoxyglucose (FDG) imaging to computed tomography (CT) scanning in differentiating benign from malignant involvement of adrenal glands in patients with lung cancer. Thirty patients with biopsy-proven lung cancer and abnormal findings on PET and/or CT scanning were studied for presence of adrenal abnormality suggestive of metastatic disease involvement (n = 26) or benign adrenal enlargement (n = 4). The results of PET and CT scanning were compared to histological findings and/or clinical follow-up for at least 1 year for presence or absence of adrenal metastases. PET-FDG imaging correctly detected the presence of metastatic involvement in 17 of 18 patients and excluded metastatic involvement in 11 of 12 patients for sensitivity, specificity, and accuracy of 94.4%, 91.6%, and 93.3%, respectively. CT scanning showed enlarged adrenals without metastases in 8 of 30 patients and normal-sized adrenals in the presence of metastases in 5 of 30 patients. There was a false-positive PET finding in 1 patient and a false-negative PET finding in another patient. PET-FDG imaging is a highly sensitive, specific, and accurate test to differentiate benign from malignant involvement of adrenal glands in patients with lung cancer and often ambiguous findings on CT scanning.
FDG PET And Adrenocortical Carcinoma: A Case Of Tumour Embolism
We present a case of adrenocortical carcinoma with IVC invasion and an unsuspected metastatic deposit in the right lung identified on FDG PET scan. This case highlights the utility of FDG PET at initial staging and its ability to detect distant metastatic disease.
18F-FDG PET/CT in the evaluation of adrenal masses
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2006
Our purpose was to evaluate the performance of (18)F-FDG PET/CT, using data from both the PET and the unenhanced CT portions of the study, in characterizing adrenal masses in oncology patients. One hundred seventy-five adrenal masses in 150 patients referred for (18)F-FDG PET/CT were assessed. Final diagnosis was based on histology (n = 6), imaging follow-up (n = 118) of 6-29 mo (mean, 14 mo), or morphologic imaging criteria (n = 51). Each adrenal mass was characterized by its size; its attenuation on CT, expressed by Hounsfield units (HU); and the intensity of (18)F-FDG uptake, expressed as standardized uptake value (SUV). Receiver operating characteristic curves were drawn to determine the optimal cutoff values of HU and SUV that would best discriminate between benign and malignant masses. When malignant lesions were compared with adenomas, PET data alone using an SUV cutoff of 3.1 yielded a sensitivity, specificity, positive predictive value, and negative predictive value of 98.5...