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

Abstract

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 SUVmax, SUVavg, T/L SUVratio and activity scores were estimated. Results: Most of the detected adrenal incidentalomas were benign (61.82%), and unilateral (77.8%). The mean T/L SUVratio was significantly higher in malignant compared to benign incidentalomas (P 1.60 showed the highest accuracy (99.09%) sensitivity (97.1%) and specificity (100%). Conclusion: The quantitative (T/L SUVratio at cut-off value > 1.60 and SUVmax 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. Keywords: Adrenal, Incidentalomas, 18F-FDG, Positron emission tomography, Computed tomography