title: Functional characterization of adrenal lesions using [123I]IMTO-SPECT/CT.
abstract: BACKGROUND
  Adrenal tumors are highly prevalent and represent a wide range of different pathological entities. Conventional imaging often provides only limited information on the origin of these lesions. Novel specific imaging methods are, therefore, of great clinical interest.
  
  
  OBJECTIVE
  We evaluated [(123)I]iodometomidate ([(123)I]IMTO) imaging for noninvasive characterization of adrenal masses.
  
  
  METHODS
  This was a prospective monocentric diagnostic study in a tertiary care center.
  
  
  METHODS
  A total of 51 patients with an adrenal lesion underwent [(123)I]IMTO imaging after injection of 185 MBq of [(123)I]IMTO. Sequential planar whole-body scans until 24 hours postinjection and single photon emission computed tomography (SPECT)/computed tomography imaging 4 to 6 hours postinjection were performed.
  
  
  METHODS
  Sensitivity and specificity of [(123)I]IMTO imaging for the noninvasive characterization of adrenal lesions were measured.
  
  
  RESULTS
  Adrenocortical tissue showed high and specific tracer uptake with a short investigation time and low radiation exposure. Qualitative analysis of SPECT/computed tomography data resulted in a sensitivity of 89% and a specificity of 85% for differentiating adrenocortical tumors from lesions of nonadrenocortical origin. Receiver-operating characteristic analysis of semiquantitative data revealed a sensitivity of 83% and a specificity of 86% for identification of adrenocortical lesions at a cutoff value of tumor to liver ratio of 1.3.
  
  
  CONCLUSIONS
  [(123)I]IMTO is a highly specific radiotracer for imaging of adrenocortical tissue with a short investigation time and low radiation exposure. Because of the general availability of SPECT technology, [(123)I]IMTO scintigraphy has the potential to become a widely used tool to noninvasively characterize the biology of adrenal lesions.
authors: Endocrinology & Diabetes Unit, University Hospital Würzburg, Oberdürrbacher Strasse 6, D-97080 Würzburg, Germany.
authors: Stefanie
authors: S
authors: Hahner
authors: Michael C
authors: MC
authors: Kreissl
authors: Martin
authors: M
authors: Fassnacht
authors: Heribert
authors: H
authors: Haenscheid
authors: Stefanie
authors: S
authors: Bock
authors: Frederik A
authors: FA
authors: Verburg
authors: Pascal
authors: P
authors: Knoedler
authors: Katharina
authors: K
authors: Lang
authors: Christoph
authors: C
authors: Reiners
authors: Andreas K
authors: AK
authors: Buck
authors: Bruno
authors: B
authors: Allolio
authors: Andreas
authors: A
authors: Schirbel
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D005045:Etomidate / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000009:adverse effects / Q000379:methods*; D049268:Positron-Emission Tomography; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes; C529450:iodophenyl metomidate; D005045:Etomidate