Objective Aim of the study was to evaluate the possible role of 18F‐FDG PET/CT to differentiate benign lesions of adrenal glands from malignant metastatic disease. We analyse the contribution of the dual time technique to achieve this propose. Material and methods We have retrospectively evaluated 33 patients (24 M, 9 F) with a mean age of 51 years (range 24‐79 years) and 36 documented adrenal masses. All patients were previously treated for primary malignancy and were submitted to PET‐CT exclude or confirm a metastatic spread. Patients were divided in two different groups (benign and malignant) on the basis of CT appearance, follow‐up and histology. 20 patients were considered malignant, while 13 benign. All 3 patients with bilateral lesions were in malignant group. Whole body18F‐FDG PET/CT were performed with low dose not enhanced CT 60 minutes after the intravenous administration of tracer. A delayed scan of the upper abdomen were obtained in all patients after 3 hours from the injection. SUV max at 1 and 3 hours were considered only in case of metabolically active mass. Results Of the 36 adrenal lesions a mild to intense 18F‐FDGuptake was demonstrated in 29. In the group of malignant lesions all of them show intense uptake at 1 hour images, with a mean SUV max of 6.7 (range 3.1‐ 14.9). In the same group mean SUV max measured at 3 hours was 7.9 (range 5.2‐17.3). Of 13 patients with benign lesionsonly 6 show increase of glucose metabolism with a mean SUV max at 1 hour of 2.2 (range 1.8‐3.3). In all 6 patients a mild reduction in SUV max was observed at 3 hours while SUV max increase during time in all malignant lesions. Conclusion In our series of patients 18F‐FDG PET/CT may have a significant role to differentiate between malign and benign adrenal masses, especially with dual time technique. In fact a mild 18F‐FDG uptake may be present in benign lesion and a single SUV max measurement may be not effective and always reproducible. On contrary dual time represent a useful technical approach to address this issue with acceptable cost, time and radiation exposure.

Dual time 18F-FDG PET/CT for the characterization of adrenal masses

PUZZIELLO, Alessandro;
2010-01-01

Abstract

Objective Aim of the study was to evaluate the possible role of 18F‐FDG PET/CT to differentiate benign lesions of adrenal glands from malignant metastatic disease. We analyse the contribution of the dual time technique to achieve this propose. Material and methods We have retrospectively evaluated 33 patients (24 M, 9 F) with a mean age of 51 years (range 24‐79 years) and 36 documented adrenal masses. All patients were previously treated for primary malignancy and were submitted to PET‐CT exclude or confirm a metastatic spread. Patients were divided in two different groups (benign and malignant) on the basis of CT appearance, follow‐up and histology. 20 patients were considered malignant, while 13 benign. All 3 patients with bilateral lesions were in malignant group. Whole body18F‐FDG PET/CT were performed with low dose not enhanced CT 60 minutes after the intravenous administration of tracer. A delayed scan of the upper abdomen were obtained in all patients after 3 hours from the injection. SUV max at 1 and 3 hours were considered only in case of metabolically active mass. Results Of the 36 adrenal lesions a mild to intense 18F‐FDGuptake was demonstrated in 29. In the group of malignant lesions all of them show intense uptake at 1 hour images, with a mean SUV max of 6.7 (range 3.1‐ 14.9). In the same group mean SUV max measured at 3 hours was 7.9 (range 5.2‐17.3). Of 13 patients with benign lesionsonly 6 show increase of glucose metabolism with a mean SUV max at 1 hour of 2.2 (range 1.8‐3.3). In all 6 patients a mild reduction in SUV max was observed at 3 hours while SUV max increase during time in all malignant lesions. Conclusion In our series of patients 18F‐FDG PET/CT may have a significant role to differentiate between malign and benign adrenal masses, especially with dual time technique. In fact a mild 18F‐FDG uptake may be present in benign lesion and a single SUV max measurement may be not effective and always reproducible. On contrary dual time represent a useful technical approach to address this issue with acceptable cost, time and radiation exposure.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11386/3939573
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