NDLI: Contemporary imaging of incidentally discovered adrenal masses.

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Contemporary imaging of incidentally discovered adrenal masses.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Wale, Daniel J. Wong, Ka Kit Viglianti, Benjamin L. Rubello, Domenico Gross, Milton D.
Description	Author Affiliation: Wale DJ ( Department of Radiology, University of Michigan Hospital, Ann Arbor, MI 48109, USA); Wong KK ( Department of Radiology, University of Michigan Hospital, Ann Arbor, MI 48109, USA.); Viglianti BL ( Department of Radiology, University of Michigan Hospital, Ann Arbor, MI 48109, USA); Rubello D ( Radiology, Medical Physics, Santa Maria della Misericordia Hospital, 45100 Rovigo, Italy.); Gross MD ( Department of Radiology, University of Michigan Hospital, Ann Arbor, MI 48109, USA)
Abstract	Adrenal lesions are routinely encountered incidentally in clinical practice. Although most of these lesions are benign, malignancy needs to be excluded. Therefore, the initial clinical workup is to exclude aggressive characteristics suggesting malignancy and to identify characteristics predictive of the most common benign lesion, an adrenal adenoma. Predicting a benign adenoma using a variety of imaging modalities has been widely studied using unenhanced computed tomography (CT), contrast enhanced CT, and magnetic resonance (MR) imaging. This review article describes the currently used imaging protocols and clinical interpretation criteria of common adrenal lesions. An adenoma can be predicted if a homogenous soft tissue adrenal mass demonstrates low attenuation (upper threshold value of 10 Hounsfield Units) on unenhanced CT, demonstrates an absolute enhancement washout of ≥ 60% and/or relative enhancement washout of ≥ 40% on adrenal washout contrast enhanced CT, or demonstrates signal loss in opposed-phased MR imaging. If an adrenal adenoma cannot be predicted based upon these criteria, the lesion should be evaluated for other imaging characteristics that suggest a specific pathology, such as an adrenal cyst or myelolipoma. Although nonspecific and with limitations, 18F-fluorodeoxyglucose (FDG) PET/CT has a potential role for differentiating benign from malignant lesions based upon the amount of radiopharmaceutical uptake with malignant lesions generally having greater uptake. If clinical and/or hormonal screening suggests a pheochromocytoma, consideration can be given to 18F-dihydroxyphenylalanine (DOPA) or 123I-metaiodobenzylguanidine (MIBG) in addition to CT and MR. Finally, this review proposes a diagnostic work-up strategy for routine use in clinical practice.
File Format	HTM / HTML
ISSN	07533322
Volume Number	87
e-ISSN	19506007
Journal	Biomedicine & Pharmacotherapy
Language	English
Publisher	Elsevier
Publisher Date	2017-03-01
Publisher Place	France
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pharmacology Adrenal Gland Neoplasms Diagnostic Imaging Methods Incidental Findings Animals Humans Magnetic Resonance Imaging Positron-emission Tomography Radiopharmaceuticals Administration & Dosage Tomography, X-ray Computed Journal Article Review
Content Type	Text
Resource Type	Article
Subject	Medicine Pharmacology

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