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首页> 外文期刊>Endocrine Connections >Diagnostic efficacy of 18F-FDG PET/CT in patients with adrenal incidentaloma
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Diagnostic efficacy of 18F-FDG PET/CT in patients with adrenal incidentaloma

机译：18 F-FDG PET / CT对肾上腺偶发瘤的诊断价值

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Background The management of adrenal incidentaloma is still a challenge with respect to determining its functionality (hormone secretion) and malignancy. In this light, we performed ~(18)F-FDG PET/CT scan to assess the SUV _(max) values in different adrenal masses including Cushing syndrome, pheochromocytoma, primary hyperaldosteronism and non-functional adrenal adenomas. Methods Total 109 (73 F, 36 M) patients with adrenal mass (incidentaloma), mean age of 53.3?±?10.2 years (range, 24–70) were screened by ~(18)F-FDG PET/CT. Data of ~(18)F-FDG PET/CT imaging of the patients were assessed by the same specialist. Adrenal masses were identified according to the calculated standardized uptake values (SUVs). Clinical examination, 24-h urine cortisol, catecholamine metabolites, 1-mg dexamethasone suppression test, aldosterone/renin ratio and serum electrolytes were analyzed. Results Based on the clinical and hormonal evaluations, there were 100 patients with non-functional adrenal mass, four with cortisol-secreting, four with pheochromocytomas and one with aldosterone-secreting adenoma. Mean adrenal mass diameter of 109 patients was 2.1?±?4.3 (range, 1–6.5?cm). The ~(18)F-FDG PET/CT imaging of the patients revealed that lower SUV _(max) values were found in non-functional adrenal masses (SUV _(max) 3.2) when compared to the functional adrenal masses including four with cortisol-secreting adenoma (SUV _(max) 10.1); four with pheochromcytoma (SUV _(max) 8.7) and one with aldosterone-secreting adenomas (SUV _(max) 3.30). Cortisol-secreting (Cushing syndrome) adrenal masses showed the highest SUV _(max) value (10.1), and a cut-off SUV _(max) of 4.135 was found with an 84.6% sensitivity and 75.6% specificity cortisol-secreting adrenal adenoma. Conclusions Consistent with the similar studies, non-functional adrenal adenomas typically do not show increased FDG uptake and a certain form of functional adenoma could present various FDG uptake in FDG PET/CT. Especially functional adrenal adenomas (cortisol secreting was the highest) showed increased FDG uptake in comparison to the non-functional adrenal masses. Therefore, setting a specific SUV _(max) value in the differentiation of malignant adrenal lesion from the benign one is risky and further studies, including a high number of functional adrenal mass are needed.
机译：背景技术在确定其功能性（激素分泌）和恶性肿瘤方面，肾上腺偶发瘤的管理仍然是一个挑战。因此，我们进行了〜（18）F-FDG PET / CT扫描，以评估不同的肾上腺肿块中的SUV _（max）值，包括库欣综合征，嗜铬细胞瘤，原发性醛固酮过多症和非功能性肾上腺腺瘤。方法采用〜（18）F-FDG PET / CT筛查109例（73 F，36 M）肾上腺肿块（偶发瘤）患者，平均年龄为53.3？±10.2岁（范围24-70）。患者的〜（18）F-FDG PET / CT成像数据由同一位专家评估。根据计算的标准摄取值（SUV）识别肾上腺肿块。临床检查，24小时尿皮质醇，儿茶酚胺代谢物，1 mg地塞米松抑制试验，醛固酮/肾素比和血清电解质进行了分析。结果根据临床和激素评估，有100例肾上腺无功能性肿块，4例分泌皮质醇，4例嗜铬细胞瘤，1例醛固酮分泌腺瘤。 109例患者的平均肾上腺肿块直径为2.1±±4.3（范围为1-6.5cm）。对患者进行的〜（18）F-FDG PET / CT成像显示，与功能性肾上腺肿块相比，非功能性肾上腺肿块（SUV _（max）3.2）的SUV _（max）值更低。皮质醇分泌腺瘤（SUV _（max）10.1）;四个患有嗜铬细胞瘤（SUV _（最大）8.7）和一个醛固酮分泌腺瘤（SUV _（最大）3.30）。分泌皮质醇的（Cushing综合征）肾上腺肿块的SUV _（max）值最高（10.1），并且截断SUV _（max）的值为4.135，敏感性为84.6％，特异性为754.6％的皮质醇分泌的肾上腺腺瘤。 。结论与类似的研究一致，非功能性肾上腺腺瘤通常不显示FDG摄取增加，并且某种形式的功能性腺瘤可能在FDG PET / CT中表现出各种FDG摄取。与非功能性肾上腺肿块相比，功能性肾上腺腺瘤（皮质醇分泌最高）尤其表现出增加的FDG摄取。因此，将恶性肾上腺病变与良性病变区分开来设定特定的SUV_（max）值是有风险的，需要进一步研究，包括大量的功能性肾上腺肿块。

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