Journal of Nuclear Medicine | |
Imaging of Adrenal Incidentalomas with PET Using 11C-Metomidate and 18F-FDG | |
Anne Roivainen1  Pirjo Nuutila1  Kjell Någren1  Anna Salonen1  Heikki Minn1  Johan Friberg1  Tapio Viljanen1  Jaakko Långsjö1  Matti Välimäki1  Jorma Salmi1  | |
关键词: adrenal gland; PET; radionuclide imaging; metomidate; 18F-FDG; | |
DOI : | |
学科分类:医学(综合) | |
来源: Society of Nuclear Medicine | |
【 摘 要 】
Our aim was to evaluate the use of PET with 11C-metomidate and 18F-FDG for the diagnosis of adrenal incidentalomas. Methods: Twenty-one patients underwent hormonal screening before dynamic imaging of the upper abdomen with 11C-metomidate, and for 19 of these 21 patients, static 18F-FDG imaging followed. Uptake of 11C-metomidate and 18F-FDG in incidentalomas was quantified and correlated with the hormonal work-up and the mass size on CT (median, 2.5 cm; range, 2–10 cm). Results: The final diagnoses were hormonally active adenoma (n = 7), nonsecretory adenoma (n = 5), adrenocortical carcinoma (n = 1), pheochromocytoma (n = 2), benign noncortical tumor (n = 2), normal adrenal (n = 1), and malignant noncortical tumor (n = 3). Diagnosis was established at surgery (n = 9), percutaneous biopsy (n = 4), or follow-up (n = 8). The highest uptake of 11C-metomidate, expressed as standardized uptake value (SUV), was found in adrenocortical carcinoma (SUV = 28.0), followed by active adenomas (median SUV = 12.7), nonsecretory adenomas (median SUV = 12.2), and noncortical tumors (median SUV = 5.7). Patients with adenomas had significantly higher tumor–to–normal-adrenal 11C-metomidate SUV ratios than did patients with noncortical tumors. 18F-FDG detected 2 of 3 noncortical malignancies but failed to detect adrenal metastases from renal cell carcinoma. All inactive and most active adenomas were difficult to detect with 18F-FDG against background activity, whereas both pheochromocytomas and adrenocortical carcinoma showed slightly increased uptake of 18F-FDG. There was no correlation between uptake of 11C-metomidate or 18F-FDG and mass size. Conclusion: 11C-Metomidate is a promising PET tracer to identify incidentalomas of adrenocortical origin. 18F-FDG should be reserved for patients with a moderate to high likelihood of neoplastic disease.
【 授权许可】
Unknown
【 预 览 】
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RO201912010195935ZK.pdf | 618KB | download |