Indeterminate adrenal mass in patients with cancer: evaluation at PET with 2-[F-18]-fluoro-2-deoxy-D-glucose.
OBJECTIVE
To evaluate the ability of positron emission tomography (PET) to characterize adrenal masses in patients with cancer.


METHODS
Twenty-four adrenal masses (size range, 1.5-10.0 cm [mean, 2.8 cm]) in 20 patients (13 men and seven women) with cancer (lung [n = 10], colon [n = 3], lymphoma [n = 3], miscellaneous [n = 4]) were evaluated. PET was performed in fasting patients 45 minutes after infusion of 5-10 mCi (185-370 MBq) of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG). PET images were correlated with findings at computed tomography (CT), surgery, and/or percutaneous biopsy.


RESULTS
Fourteen adrenal masses were proved malignant at surgery (n = 4), biopsy (n = 7), or follow-up (n = 3). Ten lesions were proved benign at biopsy (n = 4) or follow-up CT (n = 6). PET helped correct differentiation of benign from malignant adrenal lesions in all patients. A statistically significant difference (P < .001) was seen between mean tumor-to-background ratios for malignant (mean, 7.4; range, 2.9-16.6; median, 6.9) versus benign (mean, 0.8; range, 0.2-1.2; median, 0.6) adrenal lesions.


CONCLUSIONS
PET helped correct differentiation of benign from malignant adrenal lesions.
Boland
G W
GW
Department of Radiology, Massachusetts General Hospital, Boston 02114.
Goldberg
M A
MA
Lee
M J
MJ
Mayo-Smith
W W
WW
Dixon
J
J
McNicholas
M M
MM
Mueller
P R
PR
D000307:Adrenal Gland Diseases / Q000000981:diagnostic imaging; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging*; D000368:Aged; D003847:Deoxyglucose / Q000031:analogs & derivatives*; D003937:Diagnosis, Differential; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D014055:Tomography, Emission-Computed
D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose