title: Adrenal (131)I-6β-iodomethylnorcholesterol scintigraphy in choosing the side for adrenalectomy in bilateral adrenal tumors with subclinical hypercortisolemia.
abstract: OBJECTIVE
  Adrenal scintigraphy with 131I-6β-iodomethylnorcholesterol is considered by several authors the gold standard for assessing tumors with subclinical hypercortisolemia. However, most of the described series consist mainly of cases with unilateral lesions. The aim of our study was to assess whether scintigraphy is useful in choosing the adrenalectomy side in the case of bilateral adrenal tumors with subclinical hypercortisolemia.
  
  
  METHODS
  The study focused on 15 consecutive patients with benign bilateral adrenal tumors and subclinical hypercortisolemia. The scintigraphy with 131I-6β-iodomethylnorcholesterol was performed. Fourteen patients underwent unilateral adrenalectomy; the gland with predominant uptake on scintigraphy was removed. Cortisol and ACTH concentrations were measured one and six months after surgery. Post-dexamethasone cortisolemia was assessed six months after surgery. To date, the patients have been under postoperative observation for 1-4 years.
  
  
  RESULTS
  Four patients showed unilateral uptake of radiotracer, and nine patients showed predominant accumulation of radiotracer in one of the adrenal glands. The smaller tumor was predominant in 2 cases. Percentage of activity on the predominant side correlates positively with the difference between tumors' diameters. Unilateral uptake of radiotracer predicts long-lasting postoperative insufficiency of the second adrenal gland. Excision of predominating tumor led to cessation of hypercortisolemia in all patients.
  
  
  CONCLUSIONS
  The corticoadrenal scintigraphy is useful in choosing the side for operation in the case of bilateral adrenal tumors with subclinical hypercortisolemia.
authors.affiliation: Department of Endocrinology, Medical Center of Postgraduate Education, CMKP, ul. Marymoncka 99, 01-809, Warsaw, Poland. lucyferysia@wp.pl.|Department of Internal Diseases, Metabolism and Endocrinology, Bielański Hospital, Szpital Bielański, ul. Cegłowska 80, 01-809, Warsaw, Poland. lucyferysia@wp.pl.
authors.forename: Lucyna
authors.initials: L
authors.lastname: Papierska
authors.affiliation: Department of Radiology, The Faculty of Medical Sciences, University of Warmia and Mazury, Uniwersytet Warmińsko-Mazurski, ul. Warszawska 30, 10-082, Olsztyn, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Ćwikła
authors.affiliation: Department of Internal Diseases, Diabetology and Endocrinology, Medical University of Warsaw, Mazowiecki Szpital Bródnowski, ul. Kondratowicza 8, 03-242, Warsaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Rabijewski
authors.affiliation: Department of Endocrinology, Medical Center of Postgraduate Education, CMKP, ul. Marymoncka 99, 01-809, Warsaw, Poland.|Department of Internal Diseases, Metabolism and Endocrinology, Bielański Hospital, Szpital Bielański, ul. Cegłowska 80, 01-809, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Glinicki
authors.affiliation: Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, CSKUM, ul. Banacha 1a, 02-097, Warsaw, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Otto
authors.affiliation: Department of Endocrinology, Medical Center of Postgraduate Education, CMKP, ul. Marymoncka 99, 01-809, Warsaw, Poland.|Department of Internal Diseases, Metabolism and Endocrinology, Bielański Hospital, Szpital Bielański, ul. Cegłowska 80, 01-809, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Kasperlik-Załuska
mesh_terms: D000301:Adosterol; D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D000311:Adrenal Glands / Q000000981:diagnostic imaging / Q000601:surgery; D000315:Adrenalectomy; D000368:Aged; D003480:Cushing Syndrome / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging
chemical_list: D007457:Iodine Radioisotopes; D000301:Adosterol
keywords: Adrenal scintigraphy; Bilateral adrenal tumors; Iodomethylnorcholesterol scintigraphy; Subclinical hypercortisolemia