AJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Vikram, R.
Right arrow Articles by Iyer, R. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Vikram, R.
Right arrow Articles by Iyer, R. B.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Hotlight (NEW!)
Right arrow
What's Hotlight?

Utility of PET/CT in Differentiating Benign from Malignant Adrenal Nodules in Patients with Cancer

Raghunandan Vikram1, Henry D. W. Yeung2, Homer A. Macapinlac3 and Revathy B. Iyer1

1 Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1350, Houston, TX 77030-4009.
2 Department of Nuclear Medicine and PET, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong.
3 Department of Nuclear Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX.


Figure 1
View larger version (154K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1A —49-year-old man with bronchogenic carcinoma and 1.5-cm left adrenal nodule. CT (A) and PET (B) images and fused axial (C) and coronal (D) images. Three-dimensional region of interest (ROI) is on adrenal nodule. Axial and coronal fused images were used to ensure ROI included at least two thirds of adrenal lesion.

 

Figure 2
View larger version (125K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1B —49-year-old man with bronchogenic carcinoma and 1.5-cm left adrenal nodule. CT (A) and PET (B) images and fused axial (C) and coronal (D) images. Three-dimensional region of interest (ROI) is on adrenal nodule. Axial and coronal fused images were used to ensure ROI included at least two thirds of adrenal lesion.

 

Figure 3
View larger version (134K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1C —49-year-old man with bronchogenic carcinoma and 1.5-cm left adrenal nodule. CT (A) and PET (B) images and fused axial (C) and coronal (D) images. Three-dimensional region of interest (ROI) is on adrenal nodule. Axial and coronal fused images were used to ensure ROI included at least two thirds of adrenal lesion.

 

Figure 4
View larger version (139K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1D —49-year-old man with bronchogenic carcinoma and 1.5-cm left adrenal nodule. CT (A) and PET (B) images and fused axial (C) and coronal (D) images. Three-dimensional region of interest (ROI) is on adrenal nodule. Axial and coronal fused images were used to ensure ROI included at least two thirds of adrenal lesion.

 

Figure 5
View larger version (137K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1E —49-year-old man with bronchogenic carcinoma and 1.5-cm left adrenal nodule. PET image of liver shows results of quantitative analysis of 18F-FDG uptake of liver obtained with 2D ROI on relatively homogeneous part of right lobe of liver, which was free from metastasis. Average standardized uptake value (SUV) of adrenal nodule was 1.4, and average SUV of liver was 2.3. Because its SUV was less than that of liver, nodule was considered PET negative. Finding was considered true-negative and benign on basis of imaging stability over 3 years.

 

Figure 6
View larger version (150K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2A —Example of PET-positive adrenal mass in 64-year-old man with gastric carcinoma and 2.6-cm adrenal metastatic lesion. CT (A) and PET (B) images and fused axial (C) and coronal (D) images show 3D region of interest (ROI) on adrenal nodule. Axial and coronal fused images were used to ensure that ROI included at least two thirds of adrenal lesion.

 

Figure 7
View larger version (114K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2B —Example of PET-positive adrenal mass in 64-year-old man with gastric carcinoma and 2.6-cm adrenal metastatic lesion. CT (A) and PET (B) images and fused axial (C) and coronal (D) images show 3D region of interest (ROI) on adrenal nodule. Axial and coronal fused images were used to ensure that ROI included at least two thirds of adrenal lesion.

 

Figure 8
View larger version (128K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2C —Example of PET-positive adrenal mass in 64-year-old man with gastric carcinoma and 2.6-cm adrenal metastatic lesion. CT (A) and PET (B) images and fused axial (C) and coronal (D) images show 3D region of interest (ROI) on adrenal nodule. Axial and coronal fused images were used to ensure that ROI included at least two thirds of adrenal lesion.

 

Figure 9
View larger version (140K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2D —Example of PET-positive adrenal mass in 64-year-old man with gastric carcinoma and 2.6-cm adrenal metastatic lesion. CT (A) and PET (B) images and fused axial (C) and coronal (D) images show 3D region of interest (ROI) on adrenal nodule. Axial and coronal fused images were used to ensure that ROI included at least two thirds of adrenal lesion.

 

Figure 10
View larger version (121K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 2E —Example of PET-positive adrenal mass in 64-year-old man with gastric carcinoma and 2.6-cm adrenal metastatic lesion. PET image of liver shows results of quantitative analysis of 18F-FDG uptake of liver obtained with 2D ROI on relatively homogeneous part of right lobe of liver, which was free of metastasis. Average standardized uptake value (SUV) of adrenal nodule was 8.1, greater than the 2.0 average SUV of liver. Hence lesion was considered PET positive and true-positive because it increased in size on follow-up studies, suggesting metastasis.

 

Figure 11
View larger version (10K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 3 —Box plot of average standardized uptake value for benign and malignant lesions (excluding values greater than 10; n = 6; maximum value, 39.9).

 

Figure 12
View larger version (11K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 4 —Box plot of adrenal-to-liver average standardized uptake value ratio for benign and malignant lesions (excluding outliers with ratio greater than 6; maximum value, 21).

 

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by the American Roentgen Ray Society.