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18F-FDG Uptake at Initial Staging of the Adrenocortical Cancers: A Diagnostic Tool but Not of Prognostic Value

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Abstract

Background

Adrenocortical carcinoma (ACC) is a rare cancer for which little level evidence exists to guide management. 18F-FDG PET (18F-fluorodeoxyglucose positron emission tomography) is an increasingly used diagnostic tool in patients with suspicious or indeterminate adrenal tumors. In some other solid tumors, 18F-FDG PET may offer prognostic information that can guide optimal patient treatment. The aim of the present study was to evaluate whether preoperative 18F-FDG PET based on SUVs assessments has a prognostic value in ACC patients.

Methods

A retrospective analysis was performed in patients who underwent 18F-FDG PET/CT for the evaluation of ACC. Inclusion criteria were an unequivocal diagnosis of ACC; all data from primary diagnosis available; 18F-FDG PET/CT performed prior to surgery or other treatment of the primary tumor; a minimum of 6-months follow-up for surviving patients. All 18F-FDG PET/CT procedures were reinterpreted in a blind fashion.

Results

Thirty-seven patients (23 without metastasis [M0], 14 with metastasis [M1]) fulfilled the study criteria. Median uptake values were tumor standardized uptake values (SUV)max = 11 (range: 3–56) and a tumor/liver SUVmax ratio = 4.2 (range: 1.3–15). Median follow-up was 20 months. Although classic risk factors (tumoral stage, Weiss score) were associated with poor outcome, there was no correlation between primary tumor FDG uptake with overall survival (OS) and disease free survival (DFS) in M0 patients and with overall survival in M1 patients. 18F-FDG uptake correlated inconsistently with sinister histological features, such as atypical mitoses or necrosis.

Conclusions

At initial staging, primary tumor FDG uptake in ACC patients does not correlate with OS and DFS at 2 years. Patient prognosis and treatment strategy should not be based on uptake values.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Nuclear Medicine, La Timone University Hospital, CERIMED, Aix-Marseille University, 264 rue Saint-Pierre, 13385, Marseille Cedex 5, France

    L. Tessonnier & D. Taïeb

  2. Department of Nuclear Medicine, University Hospital, Nantes, France

    C. Ansquer

  3. Department of Nuclear Medicine, Civil Hospices of Lyon, Lyon, France

    C. Bournaud

  4. Department of Endocrine Surgery, La Timone University Hospital, Aix-Marseille University, 13385, Marseille, France

    F. Sebag & F. F. Palazzo

  5. Department of Endocrine Surgery, University Hospital, Nantes, France

    E. Mirallié

  6. Department of Endocrine Surgery, Civil Hospices of Lyon, Lyon, France

    J. C. Lifante

  7. Department of Endocrinology, La Timone University Hospital, Aix-Marseille University, 13385, Marseille, France

    I. Morange

  8. Department of Endocrinology, University Hospital, Nantes, France

    D. Drui

  9. Department of Oncology, Leon Berard Cancer Centre, Lyon, France

    C. de la Foucardère

  10. Laboratory for Education and Research in Medical Information Processing (LERTIM, EA3283), Aix-Marseille University, 13385, Marseille, France

    J. Mancini

  11. Department of Public Health (SSPIM), La Timone University Hospital, Aix-Marseille University, 13385, Marseille, France

    J. Mancini

Authors
  1. L. Tessonnier
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  2. C. Ansquer
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  3. C. Bournaud
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  4. F. Sebag
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  5. E. Mirallié
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  6. J. C. Lifante
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  7. F. F. Palazzo
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  8. I. Morange
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  9. D. Drui
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  10. C. de la Foucardère
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  11. J. Mancini
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  12. D. Taïeb
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Corresponding author

Correspondence to D. Taïeb.

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Tessonnier, L., Ansquer, C., Bournaud, C. et al. 18F-FDG Uptake at Initial Staging of the Adrenocortical Cancers: A Diagnostic Tool but Not of Prognostic Value. World J Surg 37, 107–112 (2013). https://doi.org/10.1007/s00268-012-1802-y

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  • DOI: https://doi.org/10.1007/s00268-012-1802-y

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