Incidentaloma other imaging findings: Difference between revisions

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==Other Imaging Findings==
==Other Imaging Findings==
* [[FDG]]-[[PET scan|PET]] is a [[nuclear medicine]] modality that provides quantitative tomographic images after intravenous injection of a beta-radiation-emitting radiotracer (18-Fluorine) used to label 2-deoxy-d-glucose rendering fluoro-deoxyglucose ([[FDG]]).<ref name="pmid19190108">{{cite journal| author=Groussin L, Bonardel G, Silvéra S, Tissier F, Coste J, Abiven G et al.| title=18F-Fluorodeoxyglucose positron emission tomography for the diagnosis of adrenocortical tumors: a prospective study in 77 operated patients. | journal=J Clin Endocrinol Metab | year= 2009 | volume= 94 | issue= 5 | pages= 1713-22 | pmid=19190108 | doi=10.1210/jc.2008-2302 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19190108  }}</ref>
* [[FDG]]-[[PET scan|PET]] is a [[nuclear medicine]] modality that provides quantitative tomographic images after intravenous injection of a beta-radiation-emitting radiotracer (18-Fluorine) used to label 2-deoxy-d-glucose rendering fluoro-deoxyglucose ([[FDG]]).<ref name="pmid19190108">{{cite journal| author=Groussin L, Bonardel G, Silvéra S, Tissier F, Coste J, Abiven G et al.| title=18F-Fluorodeoxyglucose positron emission tomography for the diagnosis of adrenocortical tumors: a prospective study in 77 operated patients. | journal=J Clin Endocrinol Metab | year= 2009 | volume= 94 | issue= 5 | pages= 1713-22 | pmid=19190108 | doi=10.1210/jc.2008-2302 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19190108  }}</ref>
* [[Glucose]] and deoxyglucose enter cells via cell [[glucose]] transporters and undergo [[phosphorylation]], but while [[glucose]] undergoes further [[enzymatic]] breakdown, deoxyglucose becomes trapped in [[intracellular]] compartments.
* [[Glucose]] and deoxyglucose enter cells via cell [[glucose]] transporters and undergo [[phosphorylation]]. When [[glucose]] undergoes further [[enzymatic]] breakdown, deoxyglucose is trapped in the [[intracellular]] compartments.
* [[Cancer]] cells have an increased requirement for [[glucose]] and take up more [[glucose]] and deoxyglucose than normal cells.<ref name="pmid11602999">{{cite journal| author=Becherer A, Vierhapper H, Pötzi C, Karanikas G, Kurtaran A, Schmaljohann J et al.| title=FDG-PET in adrenocortical carcinoma. | journal=Cancer Biother Radiopharm | year= 2001 | volume= 16 | issue= 4 | pages= 289-95 | pmid=11602999 | doi=10.1089/108497801753131363 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11602999  }}</ref>
* [[Cancer]] cells have an increased requirement for [[glucose]] and take up more [[glucose]] and deoxyglucose than normal cells.<ref name="pmid11602999">{{cite journal| author=Becherer A, Vierhapper H, Pötzi C, Karanikas G, Kurtaran A, Schmaljohann J et al.| title=FDG-PET in adrenocortical carcinoma. | journal=Cancer Biother Radiopharm | year= 2001 | volume= 16 | issue= 4 | pages= 289-95 | pmid=11602999 | doi=10.1089/108497801753131363 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11602999  }}</ref>
* SUV values have been utilized to differentiate between [[benign]] and [[malignant]] adrenal lesions.  
* SUV values have been utilized to differentiate between [[benign]] and [[malignant]] adrenal lesions.  

Revision as of 18:08, 16 October 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

Overview

Findings on a Positron Emission Tomography (PET-CT) scan suggestive of diagnostic of incidentaloma. Cancer cells have an increased requirement for glucose and take up more glucose and deoxyglucose than normal cells. standard uptake value (SUV) values have been utilized to differentiate between benign and malignant adrenal lesions. It may be helpful in the diagnosis of incidentaloma in selected patients; those with a history of malignancy or those in which CT densitometry or washout analysis is inconclusive or suspicious for malignancy because of their high sensitivity for detecting malignancy.

Other Imaging Findings

  • FDG-PET is a nuclear medicine modality that provides quantitative tomographic images after intravenous injection of a beta-radiation-emitting radiotracer (18-Fluorine) used to label 2-deoxy-d-glucose rendering fluoro-deoxyglucose (FDG).[1]
  • Glucose and deoxyglucose enter cells via cell glucose transporters and undergo phosphorylation. When glucose undergoes further enzymatic breakdown, deoxyglucose is trapped in the intracellular compartments.
  • Cancer cells have an increased requirement for glucose and take up more glucose and deoxyglucose than normal cells.[2]
  • SUV values have been utilized to differentiate between benign and malignant adrenal lesions.
  • It may be helpful in the diagnosis of incidentaloma in selected patients; those with a history of malignancy or those in which CT densitometry or washout analysis is inconclusive or suspicious for malignancy because of their high sensitivity for detecting malignancy.[3]
  • 18F-FDG is not a specific marker for cancer cells but a marker only for increased glucose metabolism; thus, uptake can also be increased in cells with an increased energy requirement due to conditions other than cancer.[4]
PET-CT shows intense hypermetabolic lesion (SUVmax 6.3), source: Case courtesy of Dr Anna Margherita Maffione, Radiopaedia.org, rID: 33259


References

  1. Groussin L, Bonardel G, Silvéra S, Tissier F, Coste J, Abiven G; et al. (2009). "18F-Fluorodeoxyglucose positron emission tomography for the diagnosis of adrenocortical tumors: a prospective study in 77 operated patients". J Clin Endocrinol Metab. 94 (5): 1713–22. doi:10.1210/jc.2008-2302. PMID 19190108.
  2. Becherer A, Vierhapper H, Pötzi C, Karanikas G, Kurtaran A, Schmaljohann J; et al. (2001). "FDG-PET in adrenocortical carcinoma". Cancer Biother Radiopharm. 16 (4): 289–95. doi:10.1089/108497801753131363. PMID 11602999.
  3. Young WF (2007). "Clinical practice. The incidentally discovered adrenal mass". N Engl J Med. 356 (6): 601–10. doi:10.1056/NEJMcp065470. PMID 17287480.
  4. Terzolo M, Stigliano A, Chiodini I, Loli P, Furlani L, Arnaldi G; et al. (2011). "AME position statement on adrenal incidentaloma". Eur J Endocrinol. 164 (6): 851–70. doi:10.1530/EJE-10-1147. PMID 21471169.

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