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I-131 Nor-Cholesterol Nuclear imaging in Patients with Hypersecreting or Non-Hypersecreting Adrenal Adenomas
Background The aim of this study was to evaluate the diagnostic accuracy of norcholesterol radionuclide imaging in patients with adrenal tumors detected by CT or MR imaging studies. Methods. We studied 41 patients (18 M and 23 F, mean age 47 15 years) with hypersecreting (n=19) or non-hypersecreting (n=22) unilateral adrenal tumors. All patients underwent iodine-131 nor-cholesterol adrenal scintigraphy. Pathology examinations (n=26) or CT follow-up studies (n=15) were obtained. Adrenal lesions were represented by 34 adenomas, 2 cysts, 1 myelolipoma, 1 pheochromocytoma, 1 carcinoma and 2 metastases. Radionuclide studies were qualitatively evaluated and the corresponding results were classified as true-positive, true-negative, false-positive (FP) and false-negative (FN). Diagnostic sensitivity, specificity and accuracy as well as positive (PPV) and negative (NPV) predictive values were calculated. In addition, norcholesterol uptake was semi-quantitatively compared between hypersecreting and non-hypersecreting adenomas using a four-point scoring. Results. The diagnostic values of nor-cholesterol scintigraphy to identify adrenal adenomas were: sensitivity 100%, specificity 71%, accuracy 95%, PPV 94% and NPV 100%; of note, 2 FP cases were observed represented by a pheochromocytoma and a myelolipoma, while no FN findings occurred. A significantly (P=0.01) higher norcholesterol uptake was observed in hypersecreting (n=19) adenomas compared to nor-hypersecreting (n=15) lesions; however, no significant difference in or size was found in this comparative analysis. Conclusion. In the large majority of cases, adrenal scintigraphy using nor-cholesterol was able to characterize specific lesions as cortical adenomas. These findings show relevant clinical impact Particularly in patients with non-hypersecreting adenomas; in this setting, laboratory data are not helpful for lesions characterization, while radionuclide abnormalities allow tumor-type identification. However, rare as well as unusual findings of adrenal scintigraphy may be observed since nor-cholesterol uptake was also found in two non-adenoma tumors (a myelolipoma and a pheochromocytoma). Finally, the lower nor-cholesterol uptake of non-hypersecreting adenomas might suggest a normal hormone synthesis of these lesions and, thus, regular secretion.
I-131 Nor-Cholesterol Nuclear imaging in Patients with Hypersecreting or Non-Hypersecreting Adrenal Adenomas
No results.
I-131 Nor-Cholesterol Nuclear imaging in Patients with Hypersecreting or Non-Hypersecreting Adrenal Adenomas
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