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Impact of 18F-FDG PET/CT on the management of adrenocortical carcinoma: analysis of 106 patients

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Limited data are available about on value of 18F-FDG PET/CT in ACC. We evaluated the impact of PET/CT on the management of ACC.

Methods

We performed a retrospective review in patients with ACC who had undergone PET/CT. The impact of PET/CT on the management plan was evaluated by comparing the findings on PET/CT to the findings on contrast-enhanced CT. The sensitivity, specificity, and accuracy of each form of imaging were calculated. The correlations between PET/CT parameters, including maximum standardized uptake value (SUVmax), total lesion glycolysis, and decline in SUVmax after chemotherapy, and clinical outcome were evaluated.

Results

Included in the analysis were 106 patients with 180 PET/CT scans. Of the 106 patients, 7 underwent PET/CT only for initial staging, 84 underwent PET/CT only for restaging, and 15 underwent PET/CT for both initial staging and restaging. PET/CT changed the management plan in 1 of 22 patients (5 %) at initial staging and 9 of 99 patients (9 %) at restaging. In 5 of the patients in whom PET/CT changed the management plan, PET/CT showed response to chemotherapy but contrast-enhanced CT showed stable disease. Sensitivity, specificity, and accuracy were 100 %, 100 %, and 100 % for PET/CT at initial staging; 92.6 %, 100 %, and 96.4 % for CT at initial staging; 98.4 %, 100 %, and 99.5 % for PET/CT at restaging; and 96.8 %, 98.6 %, and 98.0 % for CT at restaging, respectively. No PET/CT parameters were associated with survival at either initial diagnosis or recurrence.

Conclusion

PET/CT findings could substantially change the management plan in a small proportion of patients with ACC. Although lesion detection was similar between PET/CT and CT, PET/CT may be preferred for chemotherapeutic response assessment because it may predict response before anatomic changes are detected on CT.

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Acknowledgments

We thank the staff at MD Anderson Cancer Center for their assistance and especially Ms. Richelle D. Millican, Supervisor, Diagnostic Imaging, for data collection. This report was edited by Stephanie Deming in MD Anderson’s Department of Scientific Publications.

This work was supported in part by the MD Anderson Cancer Center James E. Anderson Distinguished Professorship in Nuclear Medicine (to Dr. Macapinlac), the Society of Nuclear Medicine and Molecular Imaging 2012/2014 Wagner-Torizuka Fellowship (to Dr. Takeuchi), and the NIH/NCI under award number P30CA016672.

Conflicts of interest

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Authors and Affiliations

  1. Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1483, Houston, TX, 77030, USA

    Satoshi Takeuchi, Homer A. Macapinlac & Hubert H. Chuang

  2. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Aparna Balachandran

  3. Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Mouhammed Amir Habra

  4. Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Alexandria T. Phan

  5. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Roland L. Bassett Jr.

Authors
  1. Satoshi Takeuchi
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  2. Aparna Balachandran
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  3. Mouhammed Amir Habra
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  4. Alexandria T. Phan
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  5. Roland L. Bassett Jr.
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  6. Homer A. Macapinlac
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  7. Hubert H. Chuang
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Correspondence to Satoshi Takeuchi.

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Takeuchi, S., Balachandran, A., Habra, M.A. et al. Impact of 18F-FDG PET/CT on the management of adrenocortical carcinoma: analysis of 106 patients. Eur J Nucl Med Mol Imaging 41, 2066–2073 (2014). https://doi.org/10.1007/s00259-014-2834-3

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  • DOI: https://doi.org/10.1007/s00259-014-2834-3

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