Risk stratification of adrenal masses by [18F]FDG PET/CT: Changing tactics

被引：8

作者：

Salgues, Betty ^{[1
]}

Guerin, Carole ^{[2
]}

Amodru, Vincent ^{[3
]}

Pattou, Francois ^{[4
,5
]}

Brunaud, Laurent ^{[6
]}

Lifante, Jean-Christophe ^{[7
]}

Mirallie, Eric ^{[8
]}

Sahakian, Nicolas ^{[1
]}

Castinetti, Frederic ^{[3
]}

Loundou, Anderson ^{[9
]}

Baumstarck, Karine ^{[9
]}

Sebag, Frederic ^{[2
]}

Taieb, David ^{[1
]}

机构：

[1] Aix Marseille Univ, CHU Timone, AP HM, Serv Med Nucl,Ctr Europeen Rech Imagerie Med, 264 Rue St Pierre, F-13385 Marseille, France

[2] Aix Marseille Univ, Ctr Hosp Concept, AP HM, Serv Chirurg Gen & Endocrinienne, Marseille, France

[3] Aix Marseille Univ, Ctr Hosp Concept, AP HM, Serv Enodrinol, Marseille, France

[4] Ctr Hosp Reg Univ Lille, Serv Chirurg Endocrinienne, Lille, France

[5] Univ Lille Nord France, INSERM, Lille, France

[6] Univ Lorraine, Ctr Hosp Univ Nancy Brabois, Serv Chirurg & Unite Multidisciplinaire Chirurg E, Nancy, France

[7] Ctr Hosp Lyon Sud, Serv Chirurg Generale & Endocrinienne, Lyon, France

[8] CHU Nantes, Chirurg Cancerol Digest & Endocrinienne, Nantes, France

[9] Aix Marseille Univ, Fac Med Timone, Serv Sante Publ, Marseille, France

来源：

CLINICAL ENDOCRINOLOGY | 2021年 / 94卷 / 02期

关键词：

F-18]FDG; adrenal; adrenocortical carcinoma; computed tomography; incidentaloma; VISCERAL FAT ACCUMULATION; COMPUTED-TOMOGRAPHY; BODY-COMPOSITION; F-18-FDG PET/CT; TUMORS; CARCINOMAS; DIAGNOSIS;

D O I：

10.1111/cen.14338

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Context [F-18]FDG PET/CT improves adrenal tumour characterization. However, there is still no consensus regarding the optimal imaging biomarkers of malignancy. Objectives To assess the performance of Tumour standardized uptake value (SUV)(max):Liver SUVmax for malignancy-risk and to build and evaluate a prediction model. Design/Methods The cohort consisted of consecutive patients with adrenal masses evaluated by [F-18]FDG PET/CT. The gold standard for malignancy was based on histology or a multidisciplinary consensus in nonoperated cases. The performance of the previously reported cut-off for Tumour SUVmax:Liver SUVmax (>1.5) was evaluated in this independent cohort. Additionally, a predictive model of malignancy was built from the training cohort (previous study) and evaluated in the validation cohort (current study). Results Sixty-four patients were evaluated; 28% of them had a Cushing's syndrome. Fifty-four adrenal masses were classified as benign and 10 as malignant (including 7 adrenocortical carcinomas). Compared to benign masses, malignant lesions were larger in size, had higher unenhanced densities and higher [F-18]FDG uptake. CT-derived anthropometric parameters did not differ between benign and malignant masses. A tumour SUVmax:Liver SUVmax > 1.5 showed a good diagnostic performance: Se = 90.0%/Sp = 92.6%/PPV = 69.2%/NPV = 98.0% and accuracy = 92.2%. A predictive model based on tumour size and tumour-to-liver uptake SUVmax ratio for malignancy-risk was validated and provides a complementary approach to the ratio. Conclusions Tumour SUVmax:Liver SUVmax uptake ratio is a useful biomarker for diagnosis of adrenal masses. Another tactic would be to calculate with the model an individual risk of malignancy and integrate this information into a shared decision-making process.

引用

页码：133 / 140

页数：8