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Integrated PET-CT for the Characterization of Adrenal Gland Lesions in Cancer Patients: Diagnostic Efficacy and Interpretation Pitfalls¹

¹ From the Department of Radiology and Center for Imaging Science (S.C., K.S.L., H.Y.K., Y.K.K., M.J.C., C.A.Y.), the Department of Nuclear Medicine (B.T.K.), and the Department of Pathology (G.Y.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, South Korea. Presented as an education exhibit at the 2005 RSNA Annual Meeting. Received April 6, 2006; revision requested May 15 and received May 30; accepted May 31. All authors have no financial relationships to disclose. Address correspondence to K.S.L. (e-mail: kyungs.lee{at}samsung.com).

Integrated fluorine-18 fluorodeoxyglucose positron emission tomography (PET)–computed tomography (CT) for adrenal gland imaging in cancer patients allows early detection and accurate localization of adrenal lesions and differentiation of metastatic nodules from benign lesions, thereby facilitating treatment planning.

However, false-positive findings are encountered at integrated PET-CT in approximately 5% of adrenal lesions identified as positive at PET, including adrenal adenomas, adrenal endothelial cysts, and inflammatory and infectious lesions. Moreover, false-negative findings may be seen in adrenal meta-static lesions with hemorrhage or necrosis, small-sized (<10-mm) metastatic nodules, and metastases from pulmonary bronchioloalveolar carcinoma or carcinoid tumors.

An awareness of the potential pitfalls of integrated PET-CT enhances the diagnostic efficacy of this modality by allowing differentiation of metastatic adrenal lesions from other abnormalities.

© RSNA, 2006

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