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Differentiation of adrenal incidentalomas by qualitative and quantitative analytical data obtained by 18F-FDG positron emission tomography/computed tomography in cancer patients

Rania E. Mohamed Mohamad F. Sherif Mohamed A. Amin 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(3):764-775

Aim of the work

To evaluate the diagnostic reliability of qualitative and quantitative data of 18F-FDG PET/CT scanning in the identification and differentiation of adrenal incidentalomas discovered in cancer patients.

Materials and methods

Forty-five consecutive cancer patients (24 males and 21 females), with 54 discovered adrenal incidentalomas, were subjected to whole-body 18F-FDG PET/CT scanning protocol. For each adrenal nodule, the adrenal SUV_max, SUV_avg, T/L SUV_ratio and activity scores were estimated.

Results

Most of the detected adrenal incidentalomas were benign (61.82%), and unilateral (77.8%). The mean T/L SUV_ratio was significantly higher in malignant compared to benign incidentalomas (P?<?0.001). Most of benign incidentalomas had activity score 1 (60%), while, most of malignant incidentalomas had activity score 3 (62.5%). The ROC curves analyses of 18F-FDG PET/CT in the studied adrenal incidentalomas revealed that, for identification of malignant lesions, the T/L SUV_ratio at cut-off value >1.60 showed the highest accuracy (99.09%) sensitivity (97.1%) and specificity (100%).

Conclusion

The quantitative (T/L SUV_ratio at cut-off value?>?1.60 and SUV_max at cut-off value?>?2.97) and qualitative (activity score of?≥?2) analytic data obtained by 18F-FDG PET/CT can be considered as powerful parameters for identification and differentiation of adrenal incidentalomas in cancer patients. 相似文献