Adrenocortical carcinoma other imaging studies
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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 may be used in the diagnosis of adrenocortical carcinoma.
Other Imaging Studies
Other Imaging studies that may be used in 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 cutoff 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 diagnostic CT.
- FDG PET/CT has low sensitivity for characterization of smaller lesions, particularly for those lesions less than 10 mm in diameter.[4]
- 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.