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Contemporary adrenal scintigraphy

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Abstract

Introduction

High-resolution computed tomography (CT) and magnetic resonance (MR) imaging have replaced scintigraphy as primary imaging modalities for the evaluation of adrenal diseases.

Discussion

Thin-slice CT, CT contrast washout studies and MR pulse sequences specifically designed to identify adrenal lipid content have radically changed the approach to anatomic imaging and provide unique insight into the physical characteristics of the adrenals. With a confirmed biochemical diagnosis, further evaluation is often unnecessary, especially in diagnostic localization of diseases of the adrenal cortex. However, despite the exquisite detail afforded by anatomy-based imaging, there are not infrequently clinical situations in which the functional insight provided by scintigraphy is crucial to identify adrenal dysfunction and to assist in localization of adrenocortical and adrenomedullary disease. The introduction of hybrid PET/CT and SPECT/CT, modalities that directly integrate anatomic and functional information, redefine the radiotracer principle in the larger context of high-resolution anatomic imaging. Instead of becoming obsolete, scintigraphy is an element of a device that combines it with CT or MR to allow a direct correlation between function and anatomy, whereby the combination creates a more powerful diagnostic tool than the separate component modalities.

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References

  1. Gross MD, Korobkin M, Hussain H, et al. Adrenal gland imaging. In: Jameson JL, DeGroot LJ, editors. Endocrinology, 5th edn. Philadelphia: Saunders; 2005; p. 2425–53.

    Google Scholar 

  2. Gross MD, Rubello D, Shapiro B. Is there a future for adrenal scintigraphy? Nucl Med Commun 2002;23:197–202.

    Article  PubMed  CAS  Google Scholar 

  3. Gross MD, Shapiro B, Bui C, Shulkin B, Sisson J. Adrenal scintigraphy and metaiodobenzylguanidine therapy of neuroendocrine tumors. In: Sandler MP, Coleman RE, Patton JA, Wackers FJT, Gottschalk A, editors. Diagnostic nuclear medicine, 4th edn. Philadelphia: Lippincott Williams and Wilkins; 2003; p. 715–34.

    Google Scholar 

  4. Gross MD, Bui C, Shapiro B. Adrenocortical scintigraphy. In: Ell PJ, Gambhir SS, editors. Nuclear medicine in clinical diagnosis and treatment, 3rd edn. Edinburgh: Churchill and Livingstone; 2004; p. 45–52.

    Google Scholar 

  5. Avram A, Fig LM, Gross MD. Nuclear imaging of the adrenal gland. Semin Nucl Med 2006;36:212–27.

    Article  PubMed  Google Scholar 

  6. Eriksson B, Bergström M, Sundin A, Juhlin C, Örlefors H, Öberg K, et al. The role of PET in the localization of neuroendocrine and adrenocortical tumors. Ann N Y Acad Sci 2002;970:159–69.

    PubMed  CAS  Google Scholar 

  7. Bombardieri E, Seregni E, Villano C, Chiti A, Bajetta E. Position of nuclear medicine techniques in the diagnostic work-up of neuroendocrine tumors. Q J Nucl Med 2004;48:150–63.

    CAS  Google Scholar 

  8. Kainberger F, Kurtaran A, Keinast O, Dobrozemsky G, Czerny C, Kletter K. Hybrid imaging for endocrine diseases: new perspectives. Weiner Klin Wochen 2003;115 (Suppl 2):87–90.

    Google Scholar 

  9. Gross MD, Valk TW, Thrall JH, Beierwaltes WH. The role of pharmacologic manipulation in adrenal cortical scintigraphy. Semin Nucl Med 1981;11:128–48.

    Article  PubMed  CAS  Google Scholar 

  10. Gross MD, Shapiro, B. Scintigraphic studies in adrenal hypertension. Semin Nucl Med 1990;19:122–43.

    Article  Google Scholar 

  11. Pacak K, Eisenhofer G, Goldstein DS. Functional imaging of endocrine tumors: role of positron emission tomography. Endocr Rev 2004;25:568–80.

    Article  PubMed  Google Scholar 

  12. Minn H, Salonen A, Friberg J, Roivainen A, Viljanen T, Langsjo J, et al. Imaging of adrenal incidentalomas with PET using 11C-metomidate and 18F-FDG. J Nucl Med 2004;45:972–9.

    PubMed  CAS  Google Scholar 

  13. Zettinig G, Mitterhauser M, Wadsak W, Becherer A, Pirich C, Vierhapper H, et al. Positron emission tomography imaging of adrenal masses: 18F-fluorodeoxyglucose and the 11β-hydroxylase tracer 11C-metomidate. Eur J Nucl Med Mol Imaging 2004;31:1224–30.

    Article  PubMed  Google Scholar 

  14. Sisson JC, Frager MS, Valk TW, Gross MD, Swanson DP, Wieland DM, et al. Scintigraphic localization of pheochromocytoma. N Engl J Med 1981;305:12–7.

    Article  PubMed  CAS  Google Scholar 

  15. Rubello D, Bui C, Casara D, Gross MD, Fig LM, Shapiro B. Functional scintigraphy of the adrenal gland. Eur J Endocrinol 2002;147(1):13–28.

    Article  PubMed  CAS  Google Scholar 

  16. Gross MD, Shapiro B, Shreve P. Radionuclide imaging of the adrenal cortex. Q J Nucl Med 1999;43:224–32.

    PubMed  CAS  Google Scholar 

  17. Ilias I, Pacak K. Anatomical and functional imaging of metastatic pheochromocytoma. Ann N Y Acad Sci 2004;1018:495–504.

    Article  PubMed  CAS  Google Scholar 

  18. Mamede M, Carrasquillo JA, Chen CC, Del Corral P, Whatley M, Ilias I, et al. Discordant localization of 2-[18F]-fluoro-2-deoxy-D-glucose in 6-[18F]-fluorodopamine- and [123I]-metaiodobenzylguanidine-negative metastatic pheochromocytoma sites. Nucl Med Commun 2006;27(1):31–6.

    Article  PubMed  Google Scholar 

  19. Van der Harst E, de Herder WW, Bruining HA, Bonjer HJ, de Krijger RR, Lamberts SW, et al. 123I-metaiodobenzylguanidine and 111In-octreotide uptake in benign and malignant pheochromocytomas. J Clin Endocrinol Metab 2001;86:685–93.

    Article  PubMed  Google Scholar 

  20. Shapiro B, Gross MD, Shulkin B. Radioisotope diagnosis and therapy of malignant pheochromocytomas. Trends Endocrinol Metab 2001;12:469–75.

    Article  PubMed  CAS  Google Scholar 

  21. Eriksson B, Bergström M, Sundin A, Juhlin C, Örlefors H, Öberg K, et al. The role of PET in the localization of neuroendocrine and adrenocortical tumors. Ann N Y Acad Sci 2002;970:159–69.

    PubMed  CAS  Google Scholar 

  22. Yun M, Kim W, Alnafisi N, Lacorte L, Jang S, Alavi A. 18F-FDG PET in characterizing adrenal lesions detected on CT or MRI. J Nucl Med 2001;42:1795–9.

    PubMed  CAS  Google Scholar 

  23. Metser U, Miller E, Lerman H, Lievshitz G, Avital S, Even-Sapir E. 18F-FDG PET/CT in the evaluation of adrenal masses. J Nucl Med 2006;47:32–7.

    PubMed  Google Scholar 

  24. Sohaib SA, Hanson JA, Reznek RH, Trainer PJ, Monson JP, Grossman AB, et al. CT appearance of the adrenal glands in adrenocorticotrophic hormone-dependent Cushing syndrome. Am J Roentgenol AJR 1999;172:997–1002.

    CAS  Google Scholar 

  25. Schteingart DE, Seabold JE, Gross MD, Swanson D. Iodocholesterol adrenal tissue uptake and imaging in adrenal neoplasms. J Clin Endocrinol Metab 1981;52:1156–62.

    Article  PubMed  CAS  Google Scholar 

  26. Fig LM, Ehrmann D, Gross MD, Shapiro B, Schteingart D, Glazer D. The localization of abnormal adrenal function in the ACTH-independent Cushing syndrome. Ann Intern Med 1988;109:547–53.

    PubMed  CAS  Google Scholar 

  27. Khan TS, Sundin A, Juhlin C, Långström B, Bergström M, Eriksson B. 11C-metomidate imaging of adrenocortical cancer. Eur J Nucl Med Mol Imaging 2003;30:403–10.

    Article  PubMed  Google Scholar 

  28. Hennings J, Lindhe Ö, Bergström M, Långström B, Sundin A, Hellman P. [11C]metomidate positron emission tomography of adrenocortical tumors in correlation with histopathological findings. J Clin Endocrinol Metab 2006;91:1410–4.

    Article  PubMed  CAS  Google Scholar 

  29. Tenenbaum F, Groussin L, Foehrenbach H, Tissier F, Gouya H, Berherat J, et al. 18F-fluorodeoxyglucose positron emission tomography as a diagnostic tool for malignancy of adrenocortical tumors? Preliminary results in 13 consecutive patients. Eur J Endocrinol 2004;150:789–92.

    Article  PubMed  CAS  Google Scholar 

  30. Fassnacht M, Kenn W, Allolio B. Adrenal tumors: how to establish malignancy? J Endocrinol Invest 2004;27:387–99.

    PubMed  CAS  Google Scholar 

  31. Rao SK, Caride VJ, Ponn R, Giakovis E, Lee SH. F-18 fluorodeoxyglucose positron emission tomography-positive benign adrenal cortical adenoma: imaging features and pathologic correlation. Clin Nucl Med 2004;29(5):300–2.

    Article  PubMed  Google Scholar 

  32. Shimizu A, Oriuchi N, Tsushima Y. High [18F] 2-fluoro-2-deoxy-D-glucose (FDG) uptake of adrenocortical adenoma showing subclinical Cushing’s syndrome. Ann Nucl Med 2003;17(5):403–6.

    Article  PubMed  Google Scholar 

  33. Frilling A, Tecklenborg K, Weber F, Kühl H, Müller S, Stamatis G, et al. Importance of adrenal incidentaloma in patients with a history of malignancy. Surgery 2004;136:1289–96.

    Article  PubMed  Google Scholar 

  34. Kloos RT, Gross MD, Francis IR. Incidentally discovered adrenal masses. Endocr Rev 1995;16:460–84.

    Article  PubMed  CAS  Google Scholar 

  35. Boland GW, Lee MJ, Gazelle GS, Halpern EF, McNicholas MM, Mueller PR. Characterization of adrenal masses using unenhanced CT: an analysis of the CT literature. Am J Roentgenol AJR 1998;171:201–4.

    CAS  Google Scholar 

  36. Szolar DH, Korobkin M, Reittner P, Berghold A, Bauernhofer T, Trummer H, et al. Adrenocortical carcinomas and adrenal pheochromocytomas: mass and enhancement loss evaluation at delayed contrast-enhanced CT. Radiology 2005;234:479–85.

    PubMed  Google Scholar 

  37. Al-Hawary MM, Francis IR, Korobkin M. Non-invasive evaluation of the incidentally detected indeterminate adrenal mass. Best Pract Res Clin Endocrinol Metab 2005;19:277–92.

    Article  PubMed  Google Scholar 

  38. Sahdev A, Reznek RH. Imaging evaluation of the non-functioning indeterminate adrenal mass. Trends Endocrinol Metab 2004;15:272–6.

    Google Scholar 

  39. Korobkin M, Brodeur FJ, Francis IR, Quint LE, Dunnick NR, Londy F. CT time-attenuation washout curves of adrenal adenomas and nonadenomas. Am J Roentgenol AJR 1998;170:747–52.

    CAS  Google Scholar 

  40. Outwater EK, Siegelman ES, Radecki PD, Piccoli CW, Mitchell DG. Distinction between benign and malignant adrenal masses: value of T1-weighted chemical-shift MR imaging. A J Roentgenol AJR 1995;165:579–83.

    CAS  Google Scholar 

  41. Maurea S, Klain M, Mainolfi C, Ziviello M, Salvatore M. The diagnostic role of radionuclide imaging in evaluation of patients with nonhypersecreting adrenal masses. J Nucl Med 2004;42:884–92.

    Google Scholar 

  42. Maurea S, Caraco C, Klain M, Mainolfi M, Salvatore M. Imaging characterization of non-hypersecreting adrenal masses. Comparison between MR and radionuclide techniques. Q J Nucl Med Mol Imaging 2004;48:188–97.

    PubMed  CAS  Google Scholar 

  43. Francis IR, Korobkin M. Pheochromocytoma. Radiol Clin North Am 1996;34:1101–12.

    PubMed  CAS  Google Scholar 

  44. Ilias I, Pacak K. Diagnosis and management of tumors of the adrenal medulla. Horm Metab Res 2005;37:717–21.

    Article  PubMed  CAS  Google Scholar 

  45. Shapiro B, Sisson J, Kalff V, Glowniak J, Satterlee W, Glazer G, et al. The location of middle mediastinal pheochromocytomas. J Thorac Cardiovasc Surg 1984;87:814–20.

    PubMed  CAS  Google Scholar 

  46. Hay RV, Gross MD. Scintigraphic imaging of the adrenals and neuroectodermal tumors. In: Henkin RE, Bova D, Karesh SM, Dillehey GL, Wagner RH, Halama JR, Zimmer AM, editors. Nuclear medicine, 2nd edn. Philadelphia: Mosby; 2006; p. 820–44.

    Google Scholar 

  47. Ilias I, Shulkin B, Pacak K. New functional imaging modalities for chromaffin tumors, neuroblastoma and ganglioneuromas. Trends Endocrinol Metab 2005;16:66–72.

    Article  PubMed  CAS  Google Scholar 

  48. Trampal C, Engler H, Juhlin C, Bergström M, Långström B. Pheochromocytomas: detection with 11C hydroxyephedrine PET. Radiology 2004;230:423–8.

    PubMed  Google Scholar 

  49. Ilias I, Jorge JY, Carrasquillo JA, Chen CC, Eisenhofer G, Whatley M, et al. Superiority of 6-[18F]-fluorodopamine positron emission tomography versus [131I]-metaiodobenzylguanidine scintigraphy in the localization of metastatic pheochromocytoma. J Clin Endocrinol Metab 2003;88:4083–7.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Division of Nuclear Medicine, University of Michigan, Ann Arbor, MI, USA

    Milton D. Gross, Anca Avram & Lorraine M. Fig

  2. Nuclear Medicine Service (115), Department of Veterans Affairs Health System, 2215 Fuller Rd, Ann Arbor, MI, 48105, USA

    Milton D. Gross & Lorraine M. Fig

  3. Nuclear Medicine Service-PET Unit, S. Maria della Misericordia Rovigo Hospital, Istituto Oncologico Veneto (IOV), Rovigo, Italy

    Domenico Rubello

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  1. Milton D. Gross
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  4. Domenico Rubello
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Correspondence to Milton D. Gross.

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Gross, M.D., Avram, A., Fig, L.M. et al. Contemporary adrenal scintigraphy. Eur J Nucl Med Mol Imaging 34, 547–557 (2007). https://doi.org/10.1007/s00259-006-0265-5

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