[18F]FDG-PET/CT in adrenal lesions: diagnostic performance in different clinical settings

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2024-09-18 DOI:10.1007/s12020-024-04042-5

Martina Romanisio, Tommaso Daffara, Rosa Pitino, Alice Ferrero, Francesca Pizzolitto, Marco Zavattaro, Federica Biello, Alessandra Gennari, Alessandro Volpe, Gian Mauro Sacchetti, Paolo Marzullo, Gianluca Aimaretti, Flavia Prodam, Marina Caputo

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Abstract

Purpose

Data regarding [18^F]FDG-PET/CT for the characterization of adrenal lesions are limited. Most of the studies proposed the tumor-to-liver maximum standardized uptake values (SUVratio) > 1.5 as the best cut off to predict malignancy. The aim of the study was to calculate the optimum cut off in a heterogeneous population with adrenal lesions and evaluate the diagnostic performance SUVratio >1.5.

Patients and methods

Retrospective analysis of adrenal lesions undergoing [18^F]FDG-PET/CT (2013–2022) for different reasons (atypical adrenal incidentalomas, extra adrenal tumor staging). The diagnosis of benignity was assessed by: (i) histology; (ii) stability or minimal diameter increase (<20%/<5 mm) on 12-months follow-up for non-operated patients. The optimal SUVratio and performance of SUVratio >1.5 were calculated by ROC curves.

Results

Forty-two consecutive lesions (diameter 36.1 ± 20.3 mm, 6 bilateral) underwent [18^F]FDG-PET/CT (19F, age 61.2 ± 11.7 years). Twenty-nine lesions were benign, 11 malignant [8 metastases (2 bilateral) and 1 adrenocortical carcinoma (ACC)] and 2 pheochromocytomas. The SUVratio cut-off in our population was 1.55 (Sn 100%, Sp 73.7%, AUC 0.868), with similar values excluding pheochromocytomas and metastases (SUVratio cut-off 1.49, Sn 100%, Sp 96.3%, AUC 0.988). The SUVratio cut-off of 1.5 showed 100% Sn, 87% Sp, 73% PPV, and 100% NPV.

Conclusion

[18^F]FDG-PET/CT could help in decision making process avoiding unnecessary surgery. The SUVratio cut-off of 1.5 has a good performance in a heterogenous population.

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肾上腺病变中的[18F]FDG-PET/CT：不同临床环境中的诊断性能

目的有关[18F]FDG-PET/CT用于鉴定肾上腺病变的数据十分有限。大多数研究建议将肿瘤对肝脏的最大标准化摄取值（SUVratio）> 1.5 作为预测恶性肿瘤的最佳切点。研究的目的是在肾上腺病变的异质性人群中计算最佳切点，并评估 SUVratio > 1.5 的诊断性能。患者和方法回顾性分析因不同原因（非典型肾上腺偶发瘤、肾上腺外肿瘤分期）接受 [18F]FDG-PET/CT 检查的肾上腺病变（2013-2022 年）。良性诊断通过以下方法进行评估：(i) 组织学；(ii) 非手术患者随访 12 个月后的稳定性或最小直径增加（<20%/<5 mm）。通过 ROC 曲线计算出最佳 SUV 比率和 SUV 比率为 1.5 时的表现。29个病灶为良性，11个为恶性[8个转移瘤（2个双侧）和1个肾上腺皮质癌（ACC）]，2个为嗜铬细胞瘤。我们人群中的 SUV 比值临界值为 1.55（Sn 100%，Sp 73.7%，AUC 0.868），排除嗜铬细胞瘤和转移瘤后的数值相似（SUV 比值临界值为 1.49，Sn 100%，Sp 96.3%，AUC 0.988）。结论[18F]FDG-PET/CT有助于决策过程，避免不必要的手术。结论[18F]FDG-PET/CT有助于决策过程，避免不必要的手术。SUV 比值临界值为 1.5 在不同人群中表现良好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.