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[11C]Metomidate Positron Emission Tomography of Adrenocortical Tumors in Correlation with Histopathological Findings

Context: Adrenal incidentalomas are common findings necessitating extensive laboratory work-up and repetitive radiological examinations. Positron emission tomography (PET) using 11C-labeled metomidate (MTO) has previously been described as a tool for specific adrenocortical imaging. Objective: We ev... Full description

Journal Title: The journal of clinical endocrinology and metabolism 2006-04, Vol.91 (4), p.1410-1414
Main Author: Hennings, Joakim
Other Authors: Lindhe, Örjan , Bergström, Mats , Långström, Bengt , Sundin, Anders , Hellman, Per
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Bethesda, MD: Endocrine Society
ID: ISSN: 0021-972X
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title: [11C]Metomidate Positron Emission Tomography of Adrenocortical Tumors in Correlation with Histopathological Findings
format: Article
creator:
  • Hennings, Joakim
  • Lindhe, Örjan
  • Bergström, Mats
  • Långström, Bengt
  • Sundin, Anders
  • Hellman, Per
subjects:
  • Abridged Index Medicus
  • Adrenal Cortex Neoplasms - diagnostic imaging
  • Adrenal Cortex Neoplasms - pathology
  • Adrenal Cortex Neoplasms/pathology/radionuclide imaging
  • Adrenals. Adrenal axis. Renin-angiotensin system (diseases)
  • Aged
  • Antineoplastic Agents
  • Antineoplastic Agents/diagnostic use
  • Biological and medical sciences
  • Data Interpretation, Statistical
  • Endocrinopathies
  • Ethics
  • Etomidate - analogs & derivatives
  • Etomidate/analogs & derivatives/diagnostic use
  • Female
  • Fundamental and applied biological sciences. Psychology
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Malignant tumors
  • Medical and Health Sciences
  • Medical sciences
  • MEDICIN
  • Medicin och hälsovetenskap
  • MEDICINE
  • Middle Aged
  • Positron-Emission Tomography
  • Radiopharmaceuticals
  • Radiopharmaceuticals/diagnostic use
  • Vertebrates: endocrinology
ispartof: The journal of clinical endocrinology and metabolism, 2006-04, Vol.91 (4), p.1410-1414
description: Context: Adrenal incidentalomas are common findings necessitating extensive laboratory work-up and repetitive radiological examinations. Positron emission tomography (PET) using 11C-labeled metomidate (MTO) has previously been described as a tool for specific adrenocortical imaging. Objective: We evaluated 212 MTO-PET examinations in 173 patients to identify its role in the management of adrenal tumors. Design: Seventy-five histopathological examinations from 73 patients were retrospectively analyzed. Setting: All examinations were performed at a referral center. Patients: Patients who were operated or biopsied due to adrenal tumors had histopathological diagnoses of adrenocortical adenoma (n = 26), adrenocortical cancer (ACC; n = 13), adrenocortical hyperplasia (n = 8), pheochromocytoma (n = 6), metastasis (n = 3), and tumors of nonadrenal origin (n = 19). Main Outcome Measures: The main outcome measures were statistical analyses and findings while scrutinizing images. The hypothesis that MTO-PET is of value in the management of adrenal tumors, especially incidentaloma, was stated before data collection. Results: Sensitivity was 0.89 and specificity was 0.96 for MTO-PET in proving adrenocortical origin of the lesions. Pheochromocytomas, metastases to the adrenal gland, and nonadrenal masses were all MTO negative. PET measurements using standardized uptake values (SUV) in pathological adrenocortical tissue could differentiate lesions larger than 1–1.5 cm from normal adrenocortical tissue. SUV was higher in aldosterone-hypersecreting adenomas, and the SUV ratio between the tumor and the contralateral gland was significantly higher in all hormonally hypersecreting adenomas as well as in ACC. Conclusion: MTO-PET is a specific and sensitive method for diagnosing adrenocortical tumors. MTO-PET is useful in the imaging work-up of adrenal incidentalomas and may be beneficial for the examination of patients with primary aldosteronism or ACC.
language: eng
source:
identifier: ISSN: 0021-972X
fulltext: no_fulltext
issn:
  • 0021-972X
  • 1945-7197
  • 1945-7197
url: Link


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title[11C]Metomidate Positron Emission Tomography of Adrenocortical Tumors in Correlation with Histopathological Findings
creatorHennings, Joakim ; Lindhe, Örjan ; Bergström, Mats ; Långström, Bengt ; Sundin, Anders ; Hellman, Per
creatorcontribHennings, Joakim ; Lindhe, Örjan ; Bergström, Mats ; Långström, Bengt ; Sundin, Anders ; Hellman, Per
descriptionContext: Adrenal incidentalomas are common findings necessitating extensive laboratory work-up and repetitive radiological examinations. Positron emission tomography (PET) using 11C-labeled metomidate (MTO) has previously been described as a tool for specific adrenocortical imaging. Objective: We evaluated 212 MTO-PET examinations in 173 patients to identify its role in the management of adrenal tumors. Design: Seventy-five histopathological examinations from 73 patients were retrospectively analyzed. Setting: All examinations were performed at a referral center. Patients: Patients who were operated or biopsied due to adrenal tumors had histopathological diagnoses of adrenocortical adenoma (n = 26), adrenocortical cancer (ACC; n = 13), adrenocortical hyperplasia (n = 8), pheochromocytoma (n = 6), metastasis (n = 3), and tumors of nonadrenal origin (n = 19). Main Outcome Measures: The main outcome measures were statistical analyses and findings while scrutinizing images. The hypothesis that MTO-PET is of value in the management of adrenal tumors, especially incidentaloma, was stated before data collection. Results: Sensitivity was 0.89 and specificity was 0.96 for MTO-PET in proving adrenocortical origin of the lesions. Pheochromocytomas, metastases to the adrenal gland, and nonadrenal masses were all MTO negative. PET measurements using standardized uptake values (SUV) in pathological adrenocortical tissue could differentiate lesions larger than 1–1.5 cm from normal adrenocortical tissue. SUV was higher in aldosterone-hypersecreting adenomas, and the SUV ratio between the tumor and the contralateral gland was significantly higher in all hormonally hypersecreting adenomas as well as in ACC. Conclusion: MTO-PET is a specific and sensitive method for diagnosing adrenocortical tumors. MTO-PET is useful in the imaging work-up of adrenal incidentalomas and may be beneficial for the examination of patients with primary aldosteronism or ACC.
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subjectAbridged Index Medicus ; Adrenal Cortex Neoplasms - diagnostic imaging ; Adrenal Cortex Neoplasms - pathology ; Adrenal Cortex Neoplasms/pathology/radionuclide imaging ; Adrenals. Adrenal axis. Renin-angiotensin system (diseases) ; Aged ; Antineoplastic Agents ; Antineoplastic Agents/diagnostic use ; Biological and medical sciences ; Data Interpretation, Statistical ; Endocrinopathies ; Ethics ; Etomidate - analogs & derivatives ; Etomidate/analogs & derivatives/diagnostic use ; Female ; Fundamental and applied biological sciences. Psychology ; Humans ; Image Processing, Computer-Assisted ; Male ; Malignant tumors ; Medical and Health Sciences ; Medical sciences ; MEDICIN ; Medicin och hälsovetenskap ; MEDICINE ; Middle Aged ; Positron-Emission Tomography ; Radiopharmaceuticals ; Radiopharmaceuticals/diagnostic use ; Vertebrates: endocrinology
ispartofThe journal of clinical endocrinology and metabolism, 2006-04, Vol.91 (4), p.1410-1414
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descriptionContext: Adrenal incidentalomas are common findings necessitating extensive laboratory work-up and repetitive radiological examinations. Positron emission tomography (PET) using 11C-labeled metomidate (MTO) has previously been described as a tool for specific adrenocortical imaging. Objective: We evaluated 212 MTO-PET examinations in 173 patients to identify its role in the management of adrenal tumors. Design: Seventy-five histopathological examinations from 73 patients were retrospectively analyzed. Setting: All examinations were performed at a referral center. Patients: Patients who were operated or biopsied due to adrenal tumors had histopathological diagnoses of adrenocortical adenoma (n = 26), adrenocortical cancer (ACC; n = 13), adrenocortical hyperplasia (n = 8), pheochromocytoma (n = 6), metastasis (n = 3), and tumors of nonadrenal origin (n = 19). Main Outcome Measures: The main outcome measures were statistical analyses and findings while scrutinizing images. The hypothesis that MTO-PET is of value in the management of adrenal tumors, especially incidentaloma, was stated before data collection. Results: Sensitivity was 0.89 and specificity was 0.96 for MTO-PET in proving adrenocortical origin of the lesions. Pheochromocytomas, metastases to the adrenal gland, and nonadrenal masses were all MTO negative. PET measurements using standardized uptake values (SUV) in pathological adrenocortical tissue could differentiate lesions larger than 1–1.5 cm from normal adrenocortical tissue. SUV was higher in aldosterone-hypersecreting adenomas, and the SUV ratio between the tumor and the contralateral gland was significantly higher in all hormonally hypersecreting adenomas as well as in ACC. Conclusion: MTO-PET is a specific and sensitive method for diagnosing adrenocortical tumors. MTO-PET is useful in the imaging work-up of adrenal incidentalomas and may be beneficial for the examination of patients with primary aldosteronism or ACC.
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0Abridged Index Medicus
1Adrenal Cortex Neoplasms - diagnostic imaging
2Adrenal Cortex Neoplasms - pathology
3Adrenal Cortex Neoplasms/pathology/radionuclide imaging
4Adrenals. Adrenal axis. Renin-angiotensin system (diseases)
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8Biological and medical sciences
9Data Interpretation, Statistical
10Endocrinopathies
11Ethics
12Etomidate - analogs & derivatives
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15Fundamental and applied biological sciences. Psychology
16Humans
17Image Processing, Computer-Assisted
18Male
19Malignant tumors
20Medical and Health Sciences
21Medical sciences
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23Medicin och hälsovetenskap
24MEDICINE
25Middle Aged
26Positron-Emission Tomography
27Radiopharmaceuticals
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title[11C]Metomidate Positron Emission Tomography of Adrenocortical Tumors in Correlation with Histopathological Findings
authorHennings, Joakim ; Lindhe, Örjan ; Bergström, Mats ; Långström, Bengt ; Sundin, Anders ; Hellman, Per
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0Abridged Index Medicus
1Adrenal Cortex Neoplasms - diagnostic imaging
2Adrenal Cortex Neoplasms - pathology
3Adrenal Cortex Neoplasms/pathology/radionuclide imaging
4Adrenals. Adrenal axis. Renin-angiotensin system (diseases)
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abstractContext: Adrenal incidentalomas are common findings necessitating extensive laboratory work-up and repetitive radiological examinations. Positron emission tomography (PET) using 11C-labeled metomidate (MTO) has previously been described as a tool for specific adrenocortical imaging. Objective: We evaluated 212 MTO-PET examinations in 173 patients to identify its role in the management of adrenal tumors. Design: Seventy-five histopathological examinations from 73 patients were retrospectively analyzed. Setting: All examinations were performed at a referral center. Patients: Patients who were operated or biopsied due to adrenal tumors had histopathological diagnoses of adrenocortical adenoma (n = 26), adrenocortical cancer (ACC; n = 13), adrenocortical hyperplasia (n = 8), pheochromocytoma (n = 6), metastasis (n = 3), and tumors of nonadrenal origin (n = 19). Main Outcome Measures: The main outcome measures were statistical analyses and findings while scrutinizing images. The hypothesis that MTO-PET is of value in the management of adrenal tumors, especially incidentaloma, was stated before data collection. Results: Sensitivity was 0.89 and specificity was 0.96 for MTO-PET in proving adrenocortical origin of the lesions. Pheochromocytomas, metastases to the adrenal gland, and nonadrenal masses were all MTO negative. PET measurements using standardized uptake values (SUV) in pathological adrenocortical tissue could differentiate lesions larger than 1–1.5 cm from normal adrenocortical tissue. SUV was higher in aldosterone-hypersecreting adenomas, and the SUV ratio between the tumor and the contralateral gland was significantly higher in all hormonally hypersecreting adenomas as well as in ACC. Conclusion: MTO-PET is a specific and sensitive method for diagnosing adrenocortical tumors. MTO-PET is useful in the imaging work-up of adrenal incidentalomas and may be beneficial for the examination of patients with primary aldosteronism or ACC.
copBethesda, MD
pubEndocrine Society
pmid16403816
doi10.1210/jc.2005-2273
oafree_for_read