Keywords Parole chiave: Adrenals, Fdg, Mibg, Norcholesterol, Tumors, (3 Iodobenzyl)guanidine I 131, Cholesterol Derivative, Fluorodeoxyglucose F 18, Radioisotope, Adrenal Cancer, Adrenal Cortex Adenoma, Adrenal Cyst, Adrenal Scintiscanning, Adrenal Tumor, Adult, Aged, Article, Cancer Staging, Computer Assisted Tomography, Diagnostic Accuracy, Female, Ganglioneuroma, Human, Human Tissue, Intermethod Comparison, Lipoma, Major Clinical Study, Metastasis, Neurinoma, Nuclear Magnetic Resonance Imaging, Pheochromocytoma, Positron Emission Tomography, Prediction, Priority Journal, Sensitivity And Specificity, 19-Iodocholesterol, 3-Iodobenzylguanidine, Adrenal Gland Neoplasms, Middle Aged, Predictive Value Of Tests, Radiopharmaceuticals, (3 Iodobenzyl) Guanidine I 131,
Affiliations Affiliazioni: *** IBB - CNR ***
Medicina Nucleare, Istituto Nazionale dei Tumori, via Raffaele De Cesare no. 7, 80132 Napoli, Italy
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The diagnostic role of radionuclide imaging in evaluation of patients with nonhypersecreting adrenal masses
The aim of this study was to evaluate the role of radionuclide imaging in the characterization of nonhypersecreting adrenal masses. Methods: A total of 54 patients (19 men, 35 women; mean age, 50 ± 16 y) with nonhypersecreting unilateral adrenal tumors that had been originally detected on CT or MRI underwent adrenal scintigraphy using different radiotracers. None of the patients showed specific symptoms of adrenal hypersecretion. Screening tests for excess cortical and medullary products showed normal adrenal hormone levels. Radionuclide studies (n = 73) included 131l-norcholesterol (n = 24), 131l-metaiodo-benzylguanidine (MIBG) (n = 23), and 18F-FDG PET (n = 26) scans. Results: Histology after surgery (n = 31) or adrenal biopsy (n = 23) was obtained. Adrenal lesions were represented by 19 adenomas, 4 cysts, 1 myelolipoma, 1 neurinoma, 2 ganglioneuromas, 5 pheochromocytomas, 4 pseudotumors, 6 carcinomas, 2 sarcomas, and 10 metastases (size range, 1.5- to 5-cm diameter; mean, 4.9 ± 3.1 cm). For norcholesterol imaging, diagnostic sensitivity, specificity, and accuracy were 100%, 71%, and 92%, respectively; the positive predictive value (PPV) of the norcholesterol scan to characterize an adrenal mass as an adenoma was 89%, whereas the corresponding negative predictive value (NPV) to rule out this type of tumor was 100%. For MIBG imaging, diagnostic sensitivity, specificity, and accuracy were 100%, 94%, and 96%, respectively; the PPV of the MIBG scan to characterize an adrenal mass as a medullary chromaffin tissue tumor was 83%, whereas the corresponding NPV to rule out this type of tumor was 100%. For FDG PET, diagnostic sensitivity, specificity, and accuracy were 100%, 100%, and 100%, respectively; the PPV of FDG PET to characterize an adrenal mass as a malignant tumor was 100%, whereas the corresponding NPV to rule it out was 100%. Furthermore, in 7 patients with malignant adrenal tumors, FDG whole-body scanning revealed extra-adrenal tumor sites (n = 29), allowing an accurate diagnosis of the disease's stage using a single-imaging technique. Conclusion: In patients with nonhypersecreting adrenal masses, radionuclide adrenal imaging, using specific radiopharmaceuticals such as norcholesterol, MIBG, and FDG, may provide significant functional information for tissue characterization. Norcholesterol and MIBG scans are able to detect benign tumors such as adenoma and pheochromocytoma, respectively. Conversely, FDG PET allows for recognition of malignant adrenal lesions. Therefore, adrenal scintigraphy is recommended for tumor diagnosis and, hence, for appropriate treatment planning, particularly when CT or MRI findings are inconclusive for lesion characterization.
The diagnostic role of radionuclide imaging in evaluation of patients with nonhypersecreting adrenal masses
Ntziachristos V, Cuénod CA, Fournier L, Balvay D, Pradel C, Siauve N, Clement O, Jouannot E, Lucidarme O, Vecchio SD, Salvatore M, Law B, Tung C-H, Jain RK, Fukumura D, Munn LL, Brown EB, Schellenberger E, Montet X, Weissleder R, Clerck ND, Postnov A * Tumor Imaging(280 visite) Textbook Of In Vivo Imaging In Vertebrates (ISSN: 9780-4700), 2007 Jul 16; 1: 277-309. Impact Factor:1.148 DettagliEsporta in BibTeXEsporta in EndNote
Cusanno F, Cisbani E, Colilli S, Fratoni R, Garibaldi F, Giuliani F, Gricia M, Lucentini M, Magliozzi ML, Santarivenere F, Torrioli S, Cinti MN, Pani R, Pellegrini R, Simonetti G, Schillaci O, Del Vecchio S, Salvatore M, Majewski S, De Vincentis G, Scopinaro F * Results of clinical trials with SPEM(223 visite) Nucl Instrum Methods Phys Res Sect A, 2007 Feb 1; 497(1): 46-50. Impact Factor:3.221 DettagliEsporta in BibTeXEsporta in EndNote
Aloj L, Aurilio M, Rinaldi V, D'Ambrosio L, Tesauro D, Peitl PK, Maina T, Mansi R, Von Guggenberg E, Joosten L, Sosabowski JK, Breeman WA, De Blois E, Koelewijn S, Melis M, Waser B, Beetschen K, Reubi JC, De Jong M * The EEE project(367 visite) Proc Int Cosm Ray Conf Icrc Universidad Nacional Autonoma De Mexico, 2007; 5(HEPART2): 977-980. Impact Factor:0 DettagliEsporta in BibTeXEsporta in EndNote
Hesse B, Tagil K, Cuocolo A, Anagnostopoulos C, Bardies M, Bax J, Bengel F, Busemann Sokole E, Davies G, Dondi M, Edenbrandt L, Franken P, Kjaer A, Knuuti J, Lassmann M, Ljungberg M, Marcassa C, Marie PY, Mckiddie F, O'connor M, Prvuolovich E, Underwood R * 3. 0 T perfusion MR imaging(535 visite) Rivista Di Neuroradiologia (ISSN: 1120-9976), 2004; 17(6): 807-812. Impact Factor:0.023 DettagliEsporta in BibTeXEsporta in EndNote
295 Records (274 escludendo Abstract e Conferenze). Impact factor totale: 940.601 (873.1 escludendo Abstract e Conferenze). Impact factor a 5 anni totale: 1067.187 (1000.165 escludendo Abstract e Conferenze).
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