Adrenal Imaging and Intervention

  • William W. Mayo-Smith
  • Isaac R. Francis


The objectives of this chapter are: (1) to describe the different work-ups for adrenal masses, depending on clinical scenario, (2) define adrenal incidentaloma, (3) discuss the relative risk factors for benign and malignant adrenal masses, (4) describe the imaging techniques to differentiate benign from malignant adrenal masses, and (5) discuss the recommended medical work-up of an adrenal mass.


Adrenal Mass Adrenal Adenoma Unenhanced Compute Tomography Adrenal Venous Sampling MIBG Scintigraphy 
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  1. 1.
    Miskulin J, Shulkin BL, Doherty GM et al (2003) Ispreoperative iodine 123 metaiodobenzylguanidine scintigraphy routinely necessary before initial adrenalectomy for pheochromocytoma? Surgery 134:918–923CrossRefPubMedGoogle Scholar
  2. 2.
    Greenblatt DY, Shenker Y, Chen H (2008) The utility of metaiodobenzylguanidine (MIBG) scintigraphy in patients with pheochromocytoma. Ann Surg Oncol 15:900–905CrossRefPubMedGoogle Scholar
  3. 3.
    Boland GW, Blake MA, Holalkere NS, Hahn PF (2009) PET/CT for the characterization of adrenal masses in patients with cancer: qualitative versus quantitative accuracy in 150 consecutive patients. AJR Am J Roentgenol 192:956–962CrossRefPubMedGoogle Scholar
  4. 4.
    Groussin L, Bonardel G, Silvéra S et al (2009) 18F-Fluoro-deoxyglucose positron emission tomography for the diagnosis of adrenocortical tumors: a prospective study in 77 operated patients. J Clin Endocrinol Metab 94:1713–1722CrossRefPubMedGoogle Scholar
  5. 5.
    Lee MJ, Hahn PF, Papanicolaou N et al (1991) Benign and malignant adrenal masses: CT distinction with attenuation coefficients, size, and observer analysis. Radiology 179:415–418PubMedGoogle Scholar
  6. 6.
    Korobkin, M, Brodeur FJ, Francis IR et al (1998) CT time-attenuation washout curves of adrenal adenomas and nonadenomas. AJR Am J Roentgenol 170:747–752PubMedGoogle Scholar
  7. 7.
    Boland GW, Lee MJ, Gazelle GS et al (1998) Characterization of adrenal masses using unenhanced CT: an analysis of the CT literature. AJR Am J Roentgenol 171:201–204PubMedGoogle Scholar
  8. 8.
    Bae KT, Fuangtharnthip P, Prasad SR et al (2003) Adrenal masses: CT characterization with histogram analysis method. Radiology 228:735–742CrossRefPubMedGoogle Scholar
  9. 9.
    Korobkin M, Giordano TJ, Brodeur FJ (1996) Adrenal adenomas: relationship between histologic lipid and CT and MR findings. Radiology 200:743–747PubMedGoogle Scholar
  10. 10.
    Caoili EM, Korobkin M, Francis IR et al (2002) Adrenal masses: characterization with combined unenhanced and delayed enhanced CT. Radiology 222:629–633CrossRefPubMedGoogle Scholar
  11. 11.
    Tsushima Y, Ishizaka H, Matsumoto M (1993) Adrenal masses: differentiation with chemical shift, fast low-angle shot MR imaging. Radiology 186:705PubMedGoogle Scholar
  12. 12.
    Israel GM, Korobkin M, Wang C et al (2004) Comparison of unenhanced CT and chemical shift MRI in evaluating lipidrich adrenal adenomas. AJR Am J Roentgenol 183:215–219PubMedGoogle Scholar
  13. 13.
    Fujiyoshi F, Nakajo M, Fukukura Y, Tsuchimochi S (2003) Characterization of adrenal tumors by chemical shift fast lowangle shot MR imaging: comparison of four methods of quantitative evaluation. AJR Am J Roentgenol 180:1649–1657PubMedGoogle Scholar
  14. 14.
    Mayo-Smith WW, Lee MJ, McNicholas MM et al (1995) Characterization of adrenal masses (5 cm) by use of chemical shift MR imaging: observer performance versus quantitative measures. AJR Am J Roentgenol 165:91–95PubMedGoogle Scholar
  15. 15.
    Silverman SG, Mueller PR, Pinkney LP et al (1993) Predictive value of image-guided adrenal biopsy: analysis of results of 101 biopsies. Radiology 187:715–718PubMedGoogle Scholar
  16. 16.
    Grumbach MM, Biller BM, Braunstein GD et al (2003) Management of the clinically inapparent adrenal mass (“incidentaloma”). Ann Intern Med 138:424–429PubMedGoogle Scholar
  17. 17.
    Young WF (2007) Clinical practice. The incidentally discovered adrenal mass. N Engl J Med 356:601–610CrossRefPubMedGoogle Scholar
  18. 18.
    Choyke PL (2006) ACR Appropriateness Criteria on incidentally discovered adrenal mass. J Am Coll Radiol 3:498–504CrossRefPubMedGoogle Scholar
  19. 19.
    Song JH, Chaudhry FS, Mayo-Smith WW (2008) The incidental adrenal mass on CT: Prevalence of adrenal disease in 1049 consecutive adrenal masses in patients with no known malignancy. AJR Am J Roentgenol 190:1163–1168CrossRefPubMedGoogle Scholar
  20. 20.
    NIH state-of-the-science statement on management of the clinically inapparent adrenal mass (“incidentaloma”) (2002) NIH Consens State Sci Statements 19:1–25Google Scholar
  21. 21.
    Boland GW, Blake MA, Hahn PF, Mayo-Smith WW (2008) Imaging characterization of adrenal incidentalomas: principles, techniques and algorithms. Radiology 249:756–775CrossRefPubMedGoogle Scholar

Copyright information

© Springer Verlag Italia 2010

Authors and Affiliations

  • William W. Mayo-Smith
    • 1
  • Isaac R. Francis
    • 2
  1. 1.Department of Radiology, Warren Alpert School of Medicine Brown UniversityRhode Island HospitalProvidenceUSA
  2. 2.Department of RadiologyUniversity of MichiganAnn ArborUSA

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