Advertisement

Adrenal Imaging

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

Abstract

The objectives of this chapter are to: (1) describe the different workups for adrenal masses, depending on clinical scenario, (2) define adrenal incidentaloma, (3) describe imaging techniques to differentiate benign from malignant adrenal masses, and (4) discuss recommended imaging algorithms of workup of an incidental adrenal mass.

Keywords

Adrenal Mass Adrenal Adenoma Unenhanced Compute Tomography Adrenal Incidentaloma Adrenal Venous Sampling 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Miskulin J, Shulkin BL, Doherty GM et al (2003) Is preoperative iodine 123 metaiodobenzylguanidine scintigraphy routinely necessary before initial adrenalectomy for pheochromocytoma? Surgery 134:918–923.PubMedCrossRefGoogle Scholar
  2. 2.
    Greenblatt DY, Shenker Y, Chen H (2008) The utility of metaiodobenzylguanidine (MIBG) scintigraphy in patients with pheochromocytoma. Ann Surg Oncol 15:900–905.PubMedCrossRefGoogle 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 192:956–962.PubMedCrossRefGoogle 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 94:1713–1722.PubMedCrossRefGoogle Scholar
  5. 5.
    Lee MJ, Hahn PF, Papanicolaou N et al (1991) Benign and malignant adrenal masses: CT distinction with attenuation coeff icients, size, and observer analysis. Radiology 179:415–418.PubMedCrossRefGoogle 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 170:747–752.PubMedCrossRefGoogle 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 171:201–204.PubMedCrossRefGoogle Scholar
  8. 8.
    Bae KT, Fuangtharnthip P, Prasad SR et al (2003) Adrenal masses: CT characterization with histogram analysis method. Radiology 228:735–742.PubMedCrossRefGoogle Scholar
  9. 9.
    Korobkin M, Giordano TJ, Brodeur FJ (1996) Adrenal adenomas: relationship between histologic lipid and CT and MR findings. Radiology 200:743–747.PubMedCrossRefGoogle Scholar
  10. 10.
    Caoili EM, Korobkin M, Francis IR et al (2002) Adrenal masses: characterization with combined unenhanced and delayed enhanced CT. Radiology 222:629–633.PubMedCrossRefGoogle Scholar
  11. 11.
    Gnannt R, Fischer M, Goetti R et al (2012) Dual-energy CT for characterization of the incidental adrenal mass: preliminary observations. Am J Roentgenol 198:138–144.CrossRefGoogle Scholar
  12. 12.
    Tsushima Y, Ishizaka H, Matsumoto M (1993) Adrenal masses: differentiation with chemical shift, fast low-angle shot MR imaging. Radiology 186:705.PubMedCrossRefGoogle Scholar
  13. 13.
    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 183:215–219.PubMedCrossRefGoogle Scholar
  14. 14.
    Fujiyoshi F, Nakajo M, Fukukura Y, Tsuchimochi S (2003) Characterization of adrenal tumors by chemical shift fast low-angle shot MR imaging: comparison of four methods of quantitative evaluation. AJR Am J Roentgenol 180:1649–1657.PubMedCrossRefGoogle Scholar
  15. 15.
    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 165:91–95.PubMedCrossRefGoogle Scholar
  16. 16.
    Tsushima Y, Takahashi-Taketomi A, Endo K (2009) Diagnostic utility of diffusion-weighted MR imaging and apparent diffusion coefficient value for the diagnosis of adrenal tumors. J Magn Reson Imaging 29:112–117.PubMedCrossRefGoogle Scholar
  17. 17.
    Miller FH, Wang Y, McCarthy RJ et al (2010) Utility of diffusion-weighted MRI in characterization of adrenal lesions. Am J Roentgenol 194:W179–185.CrossRefGoogle Scholar
  18. 18.
    Sandrasegaran K, Patel AA, Ramaswamy R et al (2011) Characterization of adrenal masses with diffusion weighted imaging. Am J Roentgenol 197:132–138.CrossRefGoogle Scholar
  19. 19.
    Song J, Zhang C, Liu Q et al (2012) Utility of chemical shift and diffusion-weighted imaging in characterization of hyperattenuating adrenal lesions at 3.0T. Eur J Radiol 81:2137–4320.PubMedCrossRefGoogle Scholar
  20. 20.
    Silverman SG, Mueller PR, Pinkney LP et al (1993) Predictive value of image-guided adrenal biopsy: analysis of results of 101 biopsies. Radiology 187:715–718.PubMedCrossRefGoogle Scholar
  21. 21.
    Grumbach MM, Biller BM, Braunstein GD et al (2003) Management of the clinically inapparent adrenal mass (“incidentaloma”). Ann Intern Med 138:424–429.PubMedCrossRefGoogle Scholar
  22. 22.
    Young WF (2007) Clinical practice. The incidentally discovered adrenal mass. N Engl J Med 356:601–610.PubMedCrossRefGoogle Scholar
  23. 23.
    Choyke PL (2006) ACR Appropriateness Criteria on incidentally discovered adrenal mass. J Am Coll Radiol 3:498–504.PubMedCrossRefGoogle Scholar
  24. 24.
    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 190:1163–1168.PubMedCrossRefGoogle Scholar
  25. 25.
    NIH state-of-the-science statement on management of the clinically inapparent adrenal mass (“incidentaloma”) (2002) NIH Consens State Sci Statements 19:1–25.Google Scholar
  26. 26.
    Boland GW, Blake MA, Hahn PF, Mayo-Smith WW (2008) Imaging characterization of adrenal incidentalomas: principles, techniques and algorithms. Radiology 249:756–775.PubMedCrossRefGoogle Scholar
  27. 27.
    Song JH, Grand DJ, Beland MD et al (2013) Morphologic features of 211 adrenal masses at initial contrast-enhanced CT: can we differentiate benign from malignant lesions using imaging features alone? AJR Am J Roentgenol 201:1248–1253.PubMedCrossRefGoogle Scholar
  28. 28.
    Berland LL, Silverman SG, Gore RM et al (2010) Managing incidental findings on abdominal CT: White Paper of the American College of Radiology Incidental Findings Committee. J Am Coll Radiol 7:754–773.PubMedCrossRefGoogle Scholar
  29. 29.
    Berland LL, Silverman SG, Megibow AJ, Mayo-Smith WW (2013) American College of Radiology Members’ Response to Journal of American College of Radiology White Paper on the Management of Incidental Abdominal CT Findings. J Am Coll Radiol doi: 10.1016/j.jacr.2013.06.002. [Epub ahead of print]Google Scholar
  30. 30.
    Bharwani N, Rockall AG, Sahdev A et al (2011) Adrenocortical carcinoma: the range of appearances on CT and MRI. AJR Am J Roentgenol 196:W706–W714.PubMedCrossRefGoogle Scholar
  31. 31.
    Schlund JF, Kenney PJ, Brown ED et al (1995) Adrenocorticalcarcinoma: MR imaging appearance with current techniques. J Magn Reson Imaging 5:171–174.PubMedCrossRefGoogle Scholar
  32. 32.
    Chiche L, Dousset B, Kieffer E, Chapuis Y (2006) Adrenocortical carcinoma extending into the inferior vena cava: presentation of a 15-patient series and review of the literature. Surgery 139:15–27.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2014

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

Personalised recommendations