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The role of adrenocortical scintigraphy in the evaluation of unilateral incidentally discovered adrenal and juxtaadrenal masses

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Abstract

We reviewed the findings of adrenocortical scintigraphy with131I-6-beta-iodomethyl-19-norcholesterol (NCL-6-131I) of 39 patients to clarify its role in the evaluation of unilateral adrenal or juxtaadrenal masses incidentally discovered by CT, ultrasonography or plain radiography. Twenty-seven benign adrenal masses showed various scintigraphic findings (hot nodule: 12 silent adenomas, warm nodule: one solid mass, normal appearance: one cyst and 2 solid masses, diffuse decrease: each one; solid mass, myelolipoma, ganglioneuroma and calcified adrenal and partial or complete defect: each one; solid mass, myelolipoma and ganglioneuroma and 2 cysts and 2 pheochromocytomas); while a partial or complete defect was shown in a nonfunctioning carcinoma and 3 metastases and a complete defect or inhomogeneous uptake without opposite adrenal visualization was shown in 2 patients with cortisol-producing carcinoma. Therefore a hot nodule and an inhomogenous uptake or complete defect with nonvisualization of the opposite adrenal are specific to a benign tumor and a cortisol-producing carcinoma, respectively. The impaired tumor uptake of NCL-6-131I is a nonspecific finding. The scintigraphic findings of juxtaadrenal masses were normal in 4 and deviated adrenals in 2. Thus adrenocortical scintigraphy can identify silent adenomas and cortisol-producing carcinomas among the adrenal masses and may help to differentiate juxtaadrenal from adrenal masses.

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References

  1. Geelhoed GW, Drug EM: Management of the adrenal “incidentaloma”.Surgery 92: 866–874, 1982

    PubMed  CAS  Google Scholar 

  2. Prinz RA, Brooks MH, Churchill R, et al: Incidental asymptomatic adrenal masses detected by computed tomographic scanning. Is operation required?.JAMA: 701–704, 1982

  3. Siekavizza JL, Bernardino ME, Samaan NA: Suprarenal masses and its differential diagnosis.Urology 181: 625–632, 1981

    Article  Google Scholar 

  4. Glazer GM, Woolsey EJ, Borrello J, et al: Adrenal tissue characterization using MR imaging.Radiology 158: 73–79, 1986

    PubMed  CAS  Google Scholar 

  5. Mitnick JS, Bosniak MA, Megibow AJ, et al: Non-functioning adrenal adenomas discovered incidentally on computed tomography.Radiology 148: 495–499, 1983

    PubMed  CAS  Google Scholar 

  6. Reinig JW, Doppman JL, Dwyer AJ, et al: MRI of indeterminate adrenal masses.AJR 147: 493–496, 1986

    PubMed  CAS  Google Scholar 

  7. Shirkhoda A: Current diagnostic approach to adrenal abnormalities.J Comput Tomogr 8: 277–285, 1984

    Article  PubMed  CAS  Google Scholar 

  8. Chezmar JL, Robbins SM, Nelson RC et al: Adrenal masses: Characterization with T1-weighted MR imaging.Radiology 166: 357–359, 1988

    PubMed  CAS  Google Scholar 

  9. Hussain S, Belldegrun A, Seltzer SE, et al: Differentiation of malignant from benign adrenal masses: Predictive indices on computed tomography.AJR 144: 61–65, 1985

    PubMed  CAS  Google Scholar 

  10. Oliver TW, Bernardino ME, Miller JI, et al: Isolated adrenal masses in nonsmall-cell bronchogenic carcinoma.Radiology 153: 217–218, 1984

    PubMed  Google Scholar 

  11. Kojima M, Maeda M, Ogawa H, et al: New adrenal scanning agent. JNucl Med 16: 666–668, 1975

    PubMed  CAS  Google Scholar 

  12. Sarkar SD, Beierwaltes WH, Basmadjian GP, et al: A new and superior adrenal scanning agent, NP-59.J Nucl Med 16: 1038–1042, 1975

    PubMed  CAS  Google Scholar 

  13. Kazerrooni EA, Sisson JC, Gross MD, et al: Diagnostic accuracy and pitfalls of [iodine-131]6-beta-iodomethyl-19-norcholesterol(NP-59) imaging.J Nucl Med 31: 526–534, 1990

    Google Scholar 

  14. Nakajo M: Adrenal imaging with131I-Adosterol (NCL-6-131I) by diverging and pinhole methods. II. Analysis of abnormal adrenal images.Nipp Act Radiol 42: 160–187, 1982

    CAS  Google Scholar 

  15. Francis IR, Smid A, Gross MD, et al: Adrenal masses in oncologic patients: Functional and morphologic evaluation.Radiology 166: 353–356, 1988

    PubMed  CAS  Google Scholar 

  16. Gross MD, Wilton GP, Shapiro B, et al: Functional and scintigraphic evaluation of the silent adrenal mass.J Nucl Med 28: 1401–1407, 1987

    PubMed  CAS  Google Scholar 

  17. Rizza RA, Wahner HW, Spelsberg TC, et al: Visualization of nonfunctioning adrenal adenomas with iodocholesterol: Possible relationship to subcellular distribution of tracer.J Nucl Med 19: 458–463, 1978

    PubMed  CAS  Google Scholar 

  18. Nakajo M: Adrenal imaging with131I-Adosterol (NCL-6-131I) by diverging and pinhole methods. I. Analysis of normal adrenal images.Nipp Act Radiol 41: 985–997, 1981

    CAS  Google Scholar 

  19. Hasegawa Y, Nakano S, Ibuka K, et al: Concentration of99mTc-Sn-N-pyridoxyl-5-methyltryptophan, a biliary agent, in distant metastases of hepatomas.Eur J Nucl Med 10: 255–258, 1985

    Article  PubMed  CAS  Google Scholar 

  20. Nakajo M, Sakata H, Shirono K, et al: Application of ACTH stimulation to adrenal imaging with radio-iodochohsterol.Clin Nucl Med 8: 112–120, 1983

    Article  PubMed  CAS  Google Scholar 

  21. Gross MD, Shapiro B, Bouffard A, et al: Distinguishing benign from malignant euadrenal masses.Ann Intern Med 109: 613–618, 1988

    PubMed  CAS  Google Scholar 

  22. Charbonnel B, Chatal JF, Ozanne P: Does the corticoadrenal adenoma with “pre-Cushing’s syndrome” exist?.J Nucl Med 22: 1059–1161, 1981

    PubMed  CAS  Google Scholar 

  23. Copeland PM: The incidentally discovered adrenal mass.Ann Intern Med 98: 940–945, 1983.

    PubMed  CAS  Google Scholar 

  24. Grazer HS, Weyman PJ, Sagel SS, et al: Nonfunctioning adrenal masses: Incidental discovery on computed tomography.AJR 139: 81–85, 1982

    Google Scholar 

  25. Guerrero LA: Diagnostic and therapeutic approach to incidental adrenal mass.Urology 26: 435–440, 1985

    Article  PubMed  CAS  Google Scholar 

  26. Nakajo M, Shapiro B, Copp J, et al: The normal and abnormal distribution of the adrenomedullary imaging agent m-[I-131]iodobenzylguanidine(I-131 MIBG) in man: Evaluation by scintigraphy.J Nucl Med 24: 672–682, 1983

    PubMed  CAS  Google Scholar 

  27. Shapiro B, Copp JE, Sisson JC, et al: Iodine-131 metaiodobenzylguanidine for the locating of suspected pheochromocytoma: Experience in 400 cases.J Nucl Med 26: 576–585, 1985

    PubMed  CAS  Google Scholar 

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Nakajo, M., Nakabeppu, Y., Yonekura, R. et al. The role of adrenocortical scintigraphy in the evaluation of unilateral incidentally discovered adrenal and juxtaadrenal masses. Ann Nucl Med 7, 157–166 (1993). https://doi.org/10.1007/BF03164960

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