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Hormones

, Volume 12, Issue 3, pp 417–427 | Cite as

Clinical utility of FDG-PET for diagnosis of adrenal mass: a large single-center experience

  • Allison Pitts
  • Grace Ih
  • Meng Wei
  • Deepti Dhall
  • Nicholas N. Nissen
  • Alan Waxman
  • Run Yu
Research paper

Abstract

OBJECTIVE

To examine the clinical utility of 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) for diagnosing whether an adrenal mass is malignant, in contemporary clinical practice.

DESIGN

Retrospective medical record review of patients from 2 databases at a large hospital. The first database consisted of patients who underwent FDG-PET between the years 2009 to 2011 while the second database included patients who had histological diagnosis of adrenal mass between the years 1997 to 2011.

RESULTS

3.4% of 2921 patients had adrenal FDG uptake. Approximately 43% of them did not exhibit corresponding adrenal mass. FDG-PET performance parameters were better if a cutoff of SUV (standardized uptake value) ≥3 was used to define positivity. The imaging characteristics of malignant adrenal masses and pheochromocytoma were similar but differed remarkably compared to those of benign tumors. Serial imaging revealed that the malignant adrenal masses consistently exhibited high CT attenuation, while more than half of them initially exhibited SUV<3 and in some cases FDG uptake indistinguishable from the background. The FDG-PET results were confirmatory in 87% of patients, contributory in 11%, but definitely misleading in 2%.

CONCLUSIONS

FDG-PET is not required for adrenal mass diagnosis in most patients in contemporary practice but may help clinical decision making in specific situations.

Key words

FDG-PET Adrenal mass Clinical utility 

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Copyright information

© Hellenic Endocrine Society 2013

Authors and Affiliations

  • Allison Pitts
    • 1
  • Grace Ih
    • 2
  • Meng Wei
    • 3
  • Deepti Dhall
    • 4
  • Nicholas N. Nissen
    • 5
  • Alan Waxman
    • 6
  • Run Yu
    • 1
  1. 1.Division of EndocrinologyCedars-Sinai Medical CenterLos AngelesUSA
  2. 2.Department of ImagingCedars-Sinai Medical CenterLos AngelesUSA
  3. 3.Clinical AnalyticsCedars-Sinai Medical Care FoundationBeverly HillsUSA
  4. 4.Department of PathologyCedars-Sinai Medical CenterLos AngelesUSA
  5. 5.Department of SurgeryCedars-Sinai Medical CenterLos AngelesUSA
  6. 6.Department of ImagingCedars-Sinai Medical CenterLos AngelesUSA

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