ABSTRACT
Adrenal adenomas are observed in up to 7% of the population and are predominantly non-functional, increased 18F-fluorodeoxyglucose (FDG) uptake is seen in only a small portion of them on 18F-FDG positron emission tomography/computed tomography (PET/CT) imaging. In this report, we present the sequential 18F-FDG PET/CT imaging findings of 2 patients with radiologically or pathologically confirmed adrenal adenomas who had severely altered 18F-FDG uptake patterns in adrenal lesions in different imaging studies of the same patient. In light of these findings, we wanted to highlight that evaluating adrenal adenomas as cross-sectional with semi-quantitative PET/CT parameters obtained from single imaging may cause misinterpretation.
Keywords:
Adrenal adenoma, 18F-FDG, positron emission tomography
References
1
Chong S, Lee KS, Kim HY, Kim YK, Kim BT, Chung MJ, Yi CA, Kwon GY. Integrated PET-CT for the characterization of adrenal gland lesions in cancer patients: diagnostic efficacy and interpretation pitfalls. Radiographics 2006;26:1811-1824.
2
Ansquer C, Scigliano S, Mirallié E, Taïeb D, Brunaud L, Sebag F, Leux C, Drui D, Dupas B, Renaudin K, Kraeber-Bodéré F. 18F-FDG PET/CT in the characterization and surgical decision concerning adrenal masses: a prospective multicentre evaluation. Eur J Nucl Med Mol Imaging 2010;37:1669-1678.
3
Boland GW, Dwamena BA, Jagtiani Sangwaiya M, Goehler AG, Blake MA, Hahn PF, Scott JA, Kalra MK. Characterization of adrenal masses by using FDG PET: a systematic review and meta-analysis of diagnostic test performance. Radiology 2011;259:117-126.
4
Kim SJ, Lee SW, Pak K, Kim IJ, Kim K. Diagnostic accuracy of 18F-FDG PET or PET/CT for the characterization of adrenal masses: a systematic review and meta-analysis. Br J Radiol 2018;91:20170520.
5
He X, Caoili EM, Avram AM, Miller BS, Else T. 18F-FDG-PET/CT Evaluation of Indeterminate Adrenal Masses in Noncancer Patients. J Clin Endocrinol Metab 2021;106:1448-1459.
6
Takanami K, Kaneta T, Morimoto R, Satoh F, Nakamura Y, Takase K, Takahashi S. Characterization of lipid-rich adrenal tumors by FDG PET/CT: Are they hormone-secreting or not? Ann Nucl Med 2014;28:145-153.
7
Lang BH, Cowling BJ, Li JY, Wong KP, Wan KY. High False Positivity in Positron Emission Tomography is a Potential Diagnostic Pitfall in Patients with Suspected Adrenal Metastasis. World J Surg 2015;39:1902-1908.
8
Murayama R, Nishie A, Hida T, Baba S, Inokuchi J, Oda Y, Honda H. Uptake of 18F-FDG in Adrenal Adenomas Is Associated With Unenhanced CT Value and Constituent Cells. Clin Nucl Med 2019;44:943-948.