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J Nucl Med. 2008; 49 (Supplement 1):365P
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Oncology-Clinical Diagnosis: Solid Tumors

Clinical Diagnosis-Solid Tumors Posters

Adrenal masses: The additional value of FDG-PET/CT for cancer patients

Masahiro Okada1, Makoto Hosono1, Taro Shimono1, Seishi Kumano1, Kimio Usami1, Yuzuru Yamazoe1, Yoshihiro Komeya1, Yuki Kagawa1, Norio Tsuchiya1 and Takamichi Murakami1

1 Radiology, Kinki Univ., Osaka, Japan

1544

Objectives: To investigate whether integrated FDG-PET/CT can differentiate benign from malignant adrenal lesions by maximum of Standardized Uptake Value (SUVmax) and Hounsfield Number (HN) of unenhanced CT.

Methods: We studied 30 patients with 35 adrenal lesions (16 adenomas: size 16±5mm, 15 pts and 19 metastases: 24±12mm, 15 pts), who had confirmed primary malignancies (lung cancer in 23 patients, lymphoma in 2, esophageal cancer in 2, hypopharyngeal cancer in 1 and prostate cancer in 1) and a cancer screening subject in 1. All patients underwent PET/CT at 1h post FDG injection. Diagnosis of metastasis was based on interval growth (unchanged >1year =adenoma) or reduction after chemotherapy. FDG uptake and CT attenuation were measured by placing regions of interest over PET/CT images. Adrenal uptake of SUVmaxgreater double equals2.5 and <2.5 was considered metastases and adenomas, respectively. Unenhanced CT obtained by PET/CT data was considered positive for metastases based on HNgreater double equals10HU, while lesions with HN<10HU were considered adenomas. Mann-Whitney's U test was used for statistical analyses.

Results: Adrenal adenomas showed to accumulate FDG (2.1±0.5), although to a lesser degree, whereas metastases showed higher SUVmax (7.4±3.5, p<0.05). HN of adrenal adenomas (10.1±12.3HU) was lower than that of metastases (27.6±11.9HU, p<0.05). For the differentiation between adrenal adenomas and metastases, a CT threshold of 10 HU or less corresponded to a sensitivity of 56%, specificity of 95% and accuracy of 77%. And a cut-off value using SUVmax of 2.5 was 88% sensitive, 95% specific and 91% accurate. For the diagnosis of adenomas, 5 of 7 false-negative lesions by HN were correctly diagnosed by SUVmax.

Conclusions: The additional value of SUVmax allows higher accuracy for the diagnosis of adrenal lesions with cancer patients.





This Article
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Okada, M.
Right arrow Articles by Murakami, T.
PubMed
Right arrow Articles by Okada, M.
Right arrow Articles by Murakami, T.