The role of fluorodeoxyglucose-positron emission tomography/computed tomography in differentiating between benign and malignant adrenal lesions

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dc.contributor.authorKara, Pelin Ozcan
dc.contributor.authorKara, Taylan
dc.contributor.authorGedik, Gonca Kara
dc.contributor.authorKara, Fatih
dc.contributor.authorSahin, Ozlem
dc.contributor.authorGunay, Emel Ceylan
dc.contributor.authorSari, Oktay
dc.date.accessioned2020-03-26T18:17:13Z
dc.date.available2020-03-26T18:17:13Z
dc.date.issued2011
dc.departmentSelçuk Üniversitesien_US
dc.description.abstractObjectives This retrospective study was designed to investigate the clinical role of whole-body positron emission tomography/computed tomography (PET/CT) by using 2[(18)F]fluoro-2-deoxy-D-glucose (FDG), for the evaluation of adrenal lesions and to find the best index to distinguish benign from malignant lesions in various cancer patients. Materials and methods A total of 81 patients (55 male and 26 female, age range: 31-81 years, mean: 61.5) who had confirmed primary malignancies (lung cancer in 47 patients, gastrointestinal malignancies in 13 patients, malignant melanoma in one patient, renal cell cancer in three patients, mesothelioma in two patients, breast carcinoma in nine patients, cervical cancer in one patient, ovarian cancer in two patients, pheochromocytoma in one patient, unknown primary in two patients) underwent PET/CT examinations for cancer screening, staging, restaging, and detection of suspected recurrence. Of the 81 patients, 104 adrenal lesions (34 benign and 70 malignant adrenal lesions) were shown by CT. On visual analysis of PET/CT imaging, adrenal uptake was based on a three-scale grading system. For final assessment standards of references for adrenal malignant lesions was based on biopsy (n=2), interval growth, or reduction after chemotherapy. An adrenal lesion, which remained unchanged on clinical and imaging follow-up of at least 7 months (mean follow-up time 19.31 months +/- 6.46, range 7-30 months), was decided as a benign lesion. Results In adrenal malignant lesions maximum standardized uptake value (SUV(max)) (8.82 +/- 4.47) was higher than that of adrenal benign lesions (3.02 +/- 1.15, P<0.0001). In the differentiation of adrenal benign and malignant lesions, a CT threshold of 10 Hounsfield units corresponded to a sensitivity of 64.7%, specificity of 98.6%, and accuracy of 87.5%. An SUV(max) cut-off value of 2.5 corresponded to a sensitivity of 100%, specificity of 38.2%, and accuracy of 80%. An SUV(max) cut-off value of 4.2 corresponded to a sensitivity of 88.6%, specificity of 88.2%, and accuracy of 88.5%. The ratio of tumor SUV(max) to liver SUV(mean) was 3.61 +/- 1.77 for adrenal malignant lesions whereas it was 1.20 +/- 0.38 for adrenal benign lesions (P<0.0001). T/L SUV ratio cut-off value of 1.8 corresponded to a sensitivity of 87%, specificity of 91%, and accuracy of 88.5%. T/L SUV ratio cut-off value of 1.68 corresponded to a sensitivity of 90%, specificity of 91.1%, and accuracy of 90.4%. Conclusion 2-[(18)F]fluoro-2-deoxy-D-glucose-PET/CT improves the diagnostic accuracy in the differentiation of benign from malignant adrenal lesions in various cancer patients. Combined information obtained from PET/CT (SUV(max) T/L SUV ratio, visual analysis) and unenhanced CT (size, Hounsfield units measurement) is recommended for better differentiation. Nucl Med Commun 32:106-112 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. Nuclear Medicine Communications 2011, 32:106-112en_US
dc.identifier.doi10.1097/MNM.0b013e32834199e7en_US
dc.identifier.endpage112en_US
dc.identifier.issn0143-3636en_US
dc.identifier.issue2en_US
dc.identifier.pmid21085046en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage106en_US
dc.identifier.urihttps://dx.doi.org/10.1097/MNM.0b013e32834199e7
dc.identifier.urihttps://hdl.handle.net/20.500.12395/26997
dc.identifier.volume32en_US
dc.identifier.wosWOS:000286169500004en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLIPPINCOTT WILLIAMS & WILKINSen_US
dc.relation.ispartofNUCLEAR MEDICINE COMMUNICATIONSen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjectadrenal benign lesionsen_US
dc.subjectadrenal malignant lesionsen_US
dc.subjectcomputed tomographyen_US
dc.subject2-[(18)F]fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomographyen_US
dc.subjectHounsfield uniten_US
dc.titleThe role of fluorodeoxyglucose-positron emission tomography/computed tomography in differentiating between benign and malignant adrenal lesionsen_US
dc.typeArticleen_US

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