title: The optimal imaging of adrenal tumours: a comparison of different methods.
abstract: Computed tomography (CT; unenhanced, followed by contrast-enhanced examinations) is the cornerstone of imaging of adrenal tumours. Attenuation values of <10 Hounsfield units on an unenhanced CT are practically diagnostic for adenomas. When lesions cannot be characterised adequately with CT, magnetic resonance imaging (MRI) evaluation (with T1- and T2-weighted sequences and chemical shift and fat-suppression refinements) is sought. Functional nuclear medicine imaging is useful for adrenal lesions that are not adequately characterised with CT and MRI. Scintigraphy with [(131)I]-6-iodomethyl norcholesterol (a labelled cholesterol analogue) can differentiate adrenal cortical adenomas from carcinomas. Phaeochromocytomas appear as areas of abnormal and/or increased uptake of [(123)I]- and [(131)I]-meta-iodobenzylguanidine (a labelled noradrenaline analogue). The specific and useful roles of adrenal imaging include the characterisation of tumours, assessment of true tumour size, differentiation of adenomas from carcinomas and metastases, and differentiation of hyperfunctioning from non-functioning lesions. Adrenal imaging complements and assists the clinical and hormonal evaluation of adrenal tumours.
authors.affiliation: Department of Endocrinology, Elena Venizelou Hospital, Athens GR-11521, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Ilias
authors.forename: Anju
authors.initials: A
authors.lastname: Sahdev
authors.forename: Rodney H
authors.initials: RH
authors.lastname: Reznek
authors.forename: Ashley B
authors.initials: AB
authors.lastname: Grossman
authors.forename: Karel
authors.initials: K
authors.lastname: Pacak
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology; D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis / Q000473:pathology; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000473:pathology; D000313:Adrenal Medulla / Q000473:pathology; D000308:Adrenocortical Hyperfunction / Q000175:diagnosis; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods*; D005729:Ganglioneuroma / Q000175:diagnosis / Q000473:pathology; D006391:Hemangioma / Q000175:diagnosis / Q000473:pathology; D006394:Hemangiosarcoma / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis / Q000473:pathology; D008223:Lymphoma / Q000175:diagnosis / Q000473:pathology; D008279:Magnetic Resonance Imaging; D018209:Myelolipoma / Q000175:diagnosis / Q000473:pathology; D009362:Neoplasm Metastasis; D009447:Neuroblastoma / Q000175:diagnosis / Q000473:pathology; D010673:Pheochromocytoma / Q000175:diagnosis / Q000473:pathology; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging