Adrenocortical carcinoma other imaging studies: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Adrenocortical carcinoma}} | {{Adrenocortical carcinoma}} | ||
{{CMG}} {{AE}} {{AAM}} | {{CMG}}; {{AE}} {{AAM}} {{MAD}} | ||
==Overview== | ==Overview== | ||
Adrenal [[angiography]],[[venography]], positron emission tomography and MIBG may be used in the diagnosis of adrenocortical carcinoma. | [[Adrenal]] [[angiography]], [[venography]], [[positron emission tomography]] and [[Metaiodobenzylguanidine|MIBG scan]] may be used in the diagnosis of adrenocortical carcinoma. The [[Sensitivity (tests)|sensitivity]] of [[FDG]] [[PET scan|PET/CT]] was 90% for the diagnosis of [[metastases]] as compared with 88% for the diagnostic [[Computed tomography|CT]]. [[FDG]] [[PET scan|PET/CT]] is a useful modality for [[Cancer staging|staging]] ACC and evaluating local recurrence. | ||
==Other Imaging Studies== | ==Other Imaging Studies== | ||
Other | Other [[imaging]] studies that may be used in the [[diagnosis]] of adrenocortical carcinoma are: <ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/types/adrenocortical/patient/adrenocortical-treatment-pdq#section/_1</ref> | ||
*Adrenal [[angiography]] | *[[Adrenal]] [[angiography]] | ||
*Adrenal [[venography]] | *[[Adrenal]] [[venography]] | ||
*[[PET scan]] ([[positron emission tomography]] scan) | *[[PET scan]] ([[positron emission tomography]] scan) | ||
*MIBG scan | *[[Metaiodobenzylguanidine|MIBG scan]] | ||
*[[Bone scan]]s are used to visualize bone [[metastasis]] | *[[Bone scan]]s are used to visualize [[bone]] [[metastasis]] | ||
==== FDG PET/CT ==== | ==== FDG PET/CT ==== | ||
* ACC presents as a large, heterogeneous mass with intense [[FDG]] uptake.<ref name="pmid22737189" /> | * ACC presents as a large, [[heterogeneous]] mass with intense [[FDG]] uptake.<ref name="pmid22737189" /> | ||
* [[FDG]] [[PET scan|PET/CT]] had a [[Sensitivity (tests)|sensitivity]] of 100% and [[Specificity (tests)|specificity]] of 88% in distinguishing [[benign]] from [[malignant]] lesions by using | * [[FDG]] [[PET scan|PET/CT]] had a [[Sensitivity (tests)|sensitivity]] of 100% and [[Specificity (tests)|specificity]] of 88% in distinguishing [[benign]] from [[malignant]] lesions by using cut-off value above 1.45 for [[Adrenal gland|adrenal]] to [[liver]] maximum standardized uptake value (SUV). | ||
* [[PET scan|PET/CT]] cannot distinguish ACC from [[Metastasis|metastases]], [[lymphoma]], or [[pheochromocytoma]] due to the high metabolic activity of these [[tumors]].<ref name="pmid22737189">{{cite journal| author=Sundin A| title=Imaging of adrenal masses with emphasis on adrenocortical tumors. | journal=Theranostics | year= 2012 | volume= 2 | issue= 5 | pages= 516-22 | pmid=22737189 | doi=10.7150/thno.3613 | pmc=3364557 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22737189 }}</ref> | * [[PET scan|PET/CT]] cannot distinguish ACC from [[Metastasis|metastases]], [[lymphoma]], or [[pheochromocytoma]] due to the high metabolic activity of these [[tumors]].<ref name="pmid22737189">{{cite journal| author=Sundin A| title=Imaging of adrenal masses with emphasis on adrenocortical tumors. | journal=Theranostics | year= 2012 | volume= 2 | issue= 5 | pages= 516-22 | pmid=22737189 | doi=10.7150/thno.3613 | pmc=3364557 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22737189 }}</ref> | ||
* [[FDG]] [[PET scan|PET/CT]] is a useful modality for staging ACC and evaluating local recurrence. | * [[FDG]] [[PET scan|PET/CT]] is a useful modality for staging ACC and evaluating local recurrence. | ||
* Increased uptake of [[FDG]] may be seen in benign conditions including postoperative changes. | * Increased uptake of [[FDG]] may be seen in [[benign]] conditions including postoperative changes. | ||
* No significant difference in [[Accuracy and precision|accuracy]] was found between visual analysis, SUV analysis, and standardized uptake ratio (defined as the ratio of adrenal SUV activity to liver SUV activity) analysis.<ref name="pmid18397978">{{cite journal| author=Hahner S, Stuermer A, Kreissl M, Reiners C, Fassnacht M, Haenscheid H et al.| title=[123 I]Iodometomidate for molecular imaging of adrenocortical cytochrome P450 family 11B enzymes. | journal=J Clin Endocrinol Metab | year= 2008 | volume= 93 | issue= 6 | pages= 2358-65 | pmid=18397978 | doi=10.1210/jc.2008-0050 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18397978 }}</ref> | * No significant difference in [[Accuracy and precision|accuracy]] was found between visual analysis, SUV analysis, and standardized uptake ratio (defined as the ratio of [[adrenal]] SUV activity to [[liver]] SUV activity) analysis.<ref name="pmid18397978">{{cite journal| author=Hahner S, Stuermer A, Kreissl M, Reiners C, Fassnacht M, Haenscheid H et al.| title=[123 I]Iodometomidate for molecular imaging of adrenocortical cytochrome P450 family 11B enzymes. | journal=J Clin Endocrinol Metab | year= 2008 | volume= 93 | issue= 6 | pages= 2358-65 | pmid=18397978 | doi=10.1210/jc.2008-0050 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18397978 }}</ref> | ||
* The sensitivity of [[FDG]] [[PET scan|PET/CT]] was 90% for the diagnosis of [[metastases]] as compared with 88% for diagnostic [[Computed tomography|CT]]. | * The sensitivity of [[FDG]] [[PET scan|PET/CT]] was 90% for the diagnosis of [[metastases]] as compared with 88% for the diagnostic [[Computed tomography|CT]]. | ||
* [[FDG]] [[PET scan|PET/CT]] has low [[sensitivity]] for characterization of smaller lesions, particularly for those lesions less than 10 mm in diameter.<ref name="pmid16621901">{{cite journal| author=Mackie GC, Shulkin BL, Ribeiro RC, Worden FP, Gauger PG, Mody RJ et al.| title=Use of [18F]fluorodeoxyglucose positron emission tomography in evaluating locally recurrent and metastatic adrenocortical carcinoma. | journal=J Clin Endocrinol Metab | year= 2006 | volume= 91 | issue= 7 | pages= 2665-71 | pmid=16621901 | doi=10.1210/jc.2005-2612 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16621901 }}</ref> | * [[FDG]] [[PET scan|PET/CT]] has low [[sensitivity]] for characterization of smaller lesions, particularly for those lesions less than 10 mm in diameter.<ref name="pmid16621901">{{cite journal| author=Mackie GC, Shulkin BL, Ribeiro RC, Worden FP, Gauger PG, Mody RJ et al.| title=Use of [18F]fluorodeoxyglucose positron emission tomography in evaluating locally recurrent and metastatic adrenocortical carcinoma. | journal=J Clin Endocrinol Metab | year= 2006 | volume= 91 | issue= 7 | pages= 2665-71 | pmid=16621901 | doi=10.1210/jc.2005-2612 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16621901 }}</ref> | ||
* | * The intensity of [[FDG]] uptake was found to be related to survival in patients with ACC, with a maximum SUV of >10 indicating a poor [[prognosis]].<ref name="pmid16621901" /> | ||
==References== | ==References== | ||
Latest revision as of 19:22, 30 October 2017
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Adrenocortical carcinoma other imaging studies On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2] Mohammed Abdelwahed M.D[3]
Overview
Adrenal angiography, venography, positron emission tomography and MIBG scan may be used in the diagnosis of adrenocortical carcinoma. The sensitivity of FDG PET/CT was 90% for the diagnosis of metastases as compared with 88% for the diagnostic CT. FDG PET/CT is a useful modality for staging ACC and evaluating local recurrence.
Other Imaging Studies
Other imaging studies that may be used in the diagnosis of adrenocortical carcinoma are: [1]
- Adrenal angiography
- Adrenal venography
- PET scan (positron emission tomography scan)
- MIBG scan
- Bone scans are used to visualize bone metastasis
FDG PET/CT
- ACC presents as a large, heterogeneous mass with intense FDG uptake.[2]
- FDG PET/CT had a sensitivity of 100% and specificity of 88% in distinguishing benign from malignant lesions by using cut-off value above 1.45 for adrenal to liver maximum standardized uptake value (SUV).
- PET/CT cannot distinguish ACC from metastases, lymphoma, or pheochromocytoma due to the high metabolic activity of these tumors.[2]
- FDG PET/CT is a useful modality for staging ACC and evaluating local recurrence.
- Increased uptake of FDG may be seen in benign conditions including postoperative changes.
- No significant difference in accuracy was found between visual analysis, SUV analysis, and standardized uptake ratio (defined as the ratio of adrenal SUV activity to liver SUV activity) analysis.[3]
- The sensitivity of FDG PET/CT was 90% for the diagnosis of metastases as compared with 88% for the diagnostic CT.
- FDG PET/CT has low sensitivity for characterization of smaller lesions, particularly for those lesions less than 10 mm in diameter.[4]
- The intensity of FDG uptake was found to be related to survival in patients with ACC, with a maximum SUV of >10 indicating a poor prognosis.[4]
References
- ↑ National Cancer Institute. Physician Data Query Database 2015. http://www.cancer.gov/types/adrenocortical/patient/adrenocortical-treatment-pdq#section/_1
- ↑ 2.0 2.1 Sundin A (2012). "Imaging of adrenal masses with emphasis on adrenocortical tumors". Theranostics. 2 (5): 516–22. doi:10.7150/thno.3613. PMC 3364557. PMID 22737189.
- ↑ Hahner S, Stuermer A, Kreissl M, Reiners C, Fassnacht M, Haenscheid H; et al. (2008). "[123 I]Iodometomidate for molecular imaging of adrenocortical cytochrome P450 family 11B enzymes". J Clin Endocrinol Metab. 93 (6): 2358–65. doi:10.1210/jc.2008-0050. PMID 18397978.
- ↑ 4.0 4.1 Mackie GC, Shulkin BL, Ribeiro RC, Worden FP, Gauger PG, Mody RJ; et al. (2006). "Use of [18F]fluorodeoxyglucose positron emission tomography in evaluating locally recurrent and metastatic adrenocortical carcinoma". J Clin Endocrinol Metab. 91 (7): 2665–71. doi:10.1210/jc.2005-2612. PMID 16621901.