The role of adrenocortical scintigraphy in the evaluation of unilateral incidentally discovered adrenal and juxtaadrenal masses.
We reviewed the findings of adrenocortical scintigraphy with 131I-6-beta-iodomethyl-19-norcholesterol (NCL-6-131I) of 39 patients to clarify its role in the evaluation of unilateral adrenal or juxtaadrenal masses incidentally discovered by CT, ultrasonography or plain radiography. Twenty-seven benign adrenal masses showed various scintigraphic findings (hot nodule: 12 silent adenomas, warm nodule: one solid mass, normal appearance: one cyst and 2 solid masses, diffuse decrease: each one; solid mass, myelolipoma, ganglioneuroma and calcified adrenal and partial or complete defect: each one; solid mass, myelolipoma and ganglioneuroma and 2 cysts and 2 pheochromocytomas); while a partial or complete defect was shown in a nonfunctioning carcinoma and 3 metastases and a complete defect or inhomogeneous uptake without opposite adrenal visualization was shown in 2 patients with cortisol-producing carcinoma. Therefore a hot nodule and an inhomogeneous uptake or complete defect with nonvisualization of the opposite adrenal are specific to a benign tumor and a cortisol-producing carcinoma, respectively. The impaired tumor uptake of NCL-6-131I is a nonspecific finding. The scintigraphic findings of juxtaadrenal masses were normal in 4 and deviated adrenals in 2. Thus adrenocortical scintigraphy can identify silent adenomas and cortisol-producing carcinomas among the adrenal masses and may help to differentiate juxtaadrenal from adrenal masses.
Nakajo
M
M
Department of Radiology, Faculty of Medicine, Kagoshima University, Japan.
Nakabeppu
Y
Y
Yonekura
R
R
Iwashita
S
S
Goto
T
T
D015071:19-Iodocholesterol / Q000031:analogs & derivatives*; D000236:Adenoma / Q000000981:diagnostic imaging; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging*; D018246:Adrenocortical Adenoma / Q000000981:diagnostic imaging; D000328:Adult; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging; D005260:Female; D005729:Ganglioneuroma / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D018209:Myelolipoma / Q000000981:diagnostic imaging; D009442:Neurilemmoma / Q000000981:diagnostic imaging; D010673:Pheochromocytoma / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D015071:19-Iodocholesterol; C035501:6-iodomethylcholesterol