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Surg Oncol. 2018 Jun;27(2):231-235. doi: 10.1016/j.suronc.2018.04.003. Epub 2018 Apr 23.

Characterization of adrenocortical tumors by 18F-FDG PET/CT: Does steroid hormone hypersecretion status modify the uptake pattern?

Author information

1
Department of General Endocrine and Metabolic Surgery, Conception University Hospital, Aix-Marseille University, 147, Boulevard Baille, 13005, Marseille, France. Electronic address: Nunzia.paladino@ap-hm.fr.
2
Department of General Endocrine and Metabolic Surgery, Conception University Hospital, Aix-Marseille University, 147, Boulevard Baille, 13005, Marseille, France.
3
Department of Surgery, Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
4
Department of Neuropathology, La Timone University Hospital, Aix-Marseille University, 264, rue Saint Pierre, 13385, Marseille, France.
5
Department of Endocrinology, Conception University Hospital, Aix-Marseille University, 147, Boulevard Baille, 13005, Marseille, France.
6
Department of Research and Innovation, Support Unit for Clinical Research and Economic Evaluation, Aix-Marseille University, Marseille, France.
7
Department of Nuclear Medicine, La Timone University Hospital, Aix-Marseille University, Marseille, 264, rue Saint Pierre, 13385, France.

Abstract

BACKGROUND:

adrenal tumor-to-liver uptake value (Tmx:Lmx) on 18F-FDG PET/CT is an accurate and reproducible PET parameter in the distinction between benign and malignant adrenal masses. The potential impact of steroid hormone secretion on 18F-FDG uptake is still debatable. The aim of this study was to evaluate this relationship.

METHODS:

2010-2015: 73 patients who underwent adrenalectomy for adrenocortical tumors [49 secreting/(SA) and 24 non-secreting/(NSA)] were retrospectively included in the study. Fourteen were malignant. All patients underwent hormonal evaluation, functional and anatomical imaging, Weiss scoring and Ki 67 evaluation.

RESULTS:

malignant tumors exhibit higher SUVmax than benign tumors (median 7.75 vs 3.06 respectively, p < 0.001) and Tmx:Lmx was 2.7 vs 1.17 for benign tumors, p < 0.001. Tmx:Lmx was positively correlated to Weiss score (p < 0.001). No significant difference was observed for Tmx:Lmx between SA and NSA overall (p = 0.851), regardless of the subgroup of tumors analyzed. Tmx:Lmx was not correlated to tumor size (p < 0.508) or 24 h free urinary cortisol level (p < 0.522).

CONCLUSIONS:

no correlation was observed between Tmx:Lmx and hormonal status, however the correlation between ratio, malignancy and Weiss score confirm the utility of 18F-FDG PET/CT for the differentiation of benign from malignant adrenal lesions, irrespective of the hormone secretory status of the tumor. 18F-FDG PET/CT is a useful biomarker in the diagnosis of adrenal tumors, regardless of the secretion status.

KEYWORDS:

(18)F-FDG PET/CT; Adrenal masses; Hormone secretion

PMID:
29937176
DOI:
10.1016/j.suronc.2018.04.003
[Indexed for MEDLINE]

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