Abstract
Adrenocortical tumors (ACT) in adulthood and childhood vary in clinical, histopathological, molecular, prognostic, and imaging aspects. ACT are relatively common in adults, as adenomas are often found incidentally on imaging. ACT are rare in children, though they have a significantly higher prevalence in the south and southeast regions of Brazil. In clinical manifestation, adults with ACT present more frequently with glucocorticoid overproduction (Cushing syndrome), mineralocorticoid syndromes (Conn syndrome), or the excess of androgens in women. Subclinical tumors are frequently diagnosed late, associated with compression symptoms of abdominal mass. In children, the usual presentation is the virilizing syndrome or virilizing association and hypercortisolism. Histopathological grading and ACT classification in malignant and benign lesions are different for adults and children. In adults, the described criteria are the Hough, Weiss, modified Weiss, and Van Slooten. These scores are not valid for children; there are other criteria, such as proposed by Wieneke and colleagues. In molecular terms, there is also a difference related to genetic alterations found in these two populations. This review discusses the imaging findings of ACT, aiming to characterize the present differences between ACT found in adults and children. We listed several differences between magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography–computed (PET-CT) and also performed a literature review, which focuses on studied age groups of published articles in the last 10 years regarding cortical neoplasm and imaging techniques. Published studies on ACT imaging in children are rare. It is important to stress that the majority of publications related to the differentiation of malignant and benign tumors are based almost exclusively on studies in adults. A minority of articles, however, studied adults and children together, which may not be appropriate.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Elias J Jr, Muglia, VF. Lesões adrenais corticais não adenomas. CBR -Urinário, 1st ed. Rio de Janeiro: Elservier, 2013; v. 1:431–41.Search in Google Scholar
2. Fassnacht M, Libé R, Kroiss M, Allolio B. Adrenocortical carcinoma: a clinician’s update. Nat Rev Endocrinol 2011;7:323–35.10.1038/nrendo.2010.235Search in Google Scholar
3. Allolio B, Fassnacht M. Clinical review: adrenocortical carcinoma: clinical update. J Clin Endocrinol Metab 2006;91:2027–37.10.1210/jc.2005-2639Search in Google Scholar
4. Berland LL, Silverman SG, Gore RM, Mayo-Smith WW, Megibow AJ, et al. Managing incidental findings on abdominal CT: white paper of the ACR incidental findings committee. J Am Coll Radiol 2010;7:754–73.10.1016/j.jacr.2010.06.013Search in Google Scholar
5. Boland GW, Lee MJ, Gazelle GS, Halpern EF, McNicholas MM, et al. Characterization of adrenal masses using unenhanced CT: an analysis of the CT literature. Am J Roentgenol 1998;171:201–4.10.1097/00005392-199901000-00122Search in Google Scholar
6. Cagle PT, Hough AJ, Pysher TJ, Page DL, Johnson EH, et al. Comparison of adrenal cortical tumors in children and adults. Cancer 1986;14:2235–7.10.1002/1097-0142(19860601)57:11<2235::AID-CNCR2820571127>3.0.CO;2-OSearch in Google Scholar
7. Minn H, Salonen A, Friberg J, Roivainen A, Viljanen T, et al. Imaging of adrenal Incidentalomas with PET using (11)C-metomidate and (18)F-FDG. J Nuc Medic 2004;45:972–9.Search in Google Scholar
8. Lalli E, Figueiredo BC. Pediatric Adrenocortical tumors: what they can tell us on adrenal development and comparison with adult adrenal tumors. Front Endocrinol (Lausanne) 2015;6:1–9.10.3389/fendo.2015.00023Search in Google Scholar
9. Mendonca BB, Lucon AM, Menezes CA, Saldanha LB, Latronico AC, et al. Clinical, hormonal and pathological findings in a comparative study of adrenocortical neoplasms in childhood and adulthood. J Urol 1995;154:2004–9.10.1016/S0022-5347(01)66673-4Search in Google Scholar
10. Hyodo T, Megyesi K, Kahn CR, Mclean JP, Friesen HG. Adrenocortical carcinoma and hypoglycemia: evidence for production of nonsuppressible insulin-like activity by the tumor. J Clin Endocrinol Metab 1977;44:1175–84.10.1210/jcem-44-6-1175Search in Google Scholar
11. Marques-Pereira R, Delacerda L, Lacerda HM, Michalkiewicz E, Sandrini F, et al. Childhood adrenocortical tumours: a review. Hered Cancer Clin Pract 2006;4:81–9.10.1186/1897-4287-4-2-81Search in Google Scholar
12. Antonini SR, Colli LM, Ferro L, Mermejo L, Castro M. Tumores adrenocorticais na criança: da abordagem clínica à avaliação molecular. Arq Bras Endocrinol Metab 2011;55:599–606.10.1590/S0004-27302011000800014Search in Google Scholar
13. Sandrini R, Ribeiro RC, DeLacerda L. Childhood adrenocortical tumors. J Clin Endocrinol Metab 1997;82:2027–31.10.1210/jc.82.7.2027Search in Google Scholar
14. Sullivan M, Boileau M, Hodges CV. Adrenal cortical carcinoma. J Urol 1978;120:660–5.10.1016/S0022-5347(17)57317-6Search in Google Scholar
15. Sebro R, Aslam R, Muglia VF, Wang ZJ, Westphalen AC. Low yield of chemical shift MRI for characterization of adrenal lesions with high attenuation density on unenhanced CT. Abdom Imaging 2014;40:318–26.10.1007/s00261-014-0208-8Search in Google Scholar PubMed
16. Fassnacht M, Wittekind C, Allolio B. [Current TNM classification systems for adrenocortical carcinoma]. Pathologe 2010;31:374–8.10.1007/s00292-010-1306-1Search in Google Scholar PubMed
17. Fassnacht M, Johanssen S, Quinkler M, Bucsky P, Willenberg HS, et al. Limited prognostic value of the 2004 International Union Against Cancer staging classification for adrenocortical carcinoma: proposal for a revised TNM classification. Cancer 2009;115:243–50.10.1002/cncr.24030Search in Google Scholar PubMed
18. Lughezzani G, Sun M, Perrotte P, Jeldres C, Alasker A, et al. The European network for the study of adrenal tumors staging system is prognostically superior to the international union against cancer-staging system: a North American validation. Eur J Cancer 2010;46:713–9.10.1016/j.ejca.2009.12.007Search in Google Scholar PubMed
19. Wieneke JA, Thompson LD, Heffess CS. Adrenal cortical neoplasms in the pediatric population. Am J Surg Pathol 2003;27:867–81.10.1097/00000478-200307000-00001Search in Google Scholar PubMed
20. Almeida MQ, Latronico AC. The molecular pathogenesis of childhood adrenocortical tumors. Horm Metab Res 2007;39:461–6.10.1055/s-2007-981476Search in Google Scholar PubMed
21. Faria AM, Almeida MQ. Differences in the molecular mechanisms of adrenocortical tumorigenesis between children and adults. Mol Cell Endocrinol 2012;351:52–7.10.1016/j.mce.2011.09.040Search in Google Scholar PubMed
22. Morimoto R, Satoh F, Murakami O, Suzuki T, Abe T, et al. Immunohistochemistry of a proliferation marker Ki67/MIB1 in adrenocortical carcinomas: Ki67/MIB1 labeling index is a predictor for recurrence of adrenocortical carcinomas. Endocr J 2008;55:49–55.10.1507/endocrj.K07-079Search in Google Scholar PubMed
23. Weiss LM. Comparative histologic study of 43 metastasizing and nonmetastasizing adrenocortical tumors. Am J Surg Pathol 1984;8:163–9.10.1097/00000478-198403000-00001Search in Google Scholar
24. Aubert S, Wacrenier A, Leroy X, Devos P, Carnaille B, et al. Weiss system revisited: a clinicopathologic and immunohistochemical study of 49 adrenocortical tumors. Am J Surg Pathol 2002;26:1612–9.10.1097/00000478-200212000-00009Search in Google Scholar
25. Van Slooten H, Schaberg A, Smeenk D, Moolenaar JM. Morphologic characteristics of benign and malignant adrenocortical tumours. Cancer 1985;55;766–73.10.1002/1097-0142(19850215)55:4<766::AID-CNCR2820550414>3.0.CO;2-7Search in Google Scholar
26. Hough AJ, Hollified JW, Page DL, Hartmann WH. Prognostic factors in adrenal cortical tumors. A mathematical analysis of clinical and morphologic data. Am J Clin Pathol 1979;72:390–9.10.1093/ajcp/72.3.390Search in Google Scholar
27. Weiss LM, Medeiros LJ, Vickery AL Jr. Pathologic features of prognostic significance in adrenocortical carcinoma. Am J Surg Pathol 1989;13:202–6.10.1097/00000478-198903000-00004Search in Google Scholar
28. Van Slooten H, Schaberg A, Smeenk D, Moolenaar AJ. Morphologic characteristics of benign and malignant adrenocortical tumors. Cancer 1985;55:766–73.10.1002/1097-0142(19850215)55:4<766::AID-CNCR2820550414>3.0.CO;2-7Search in Google Scholar
29. Ilias I, Sahdev A, Reznek RH, Grossman AB, Pacak K. The optimal imaging of adrenal tumours: a comparison of different methods. Endocr Relat Cancer 2007;14:587–99.10.1677/ERC-07-0045Search in Google Scholar
30. Ribeiro RC, Sandrini Neto RS, Schell MJ, Lacerda L, Sambaio G, et al. Adrenocortical carcinoma in children: a study of 40 cases. J Clin Oncol 1990;8:67–74.10.1200/JCO.1990.8.1.67Search in Google Scholar
31. Dichtchekenian V, de Bragança Pereira CA, Kuperman H, Della Manna T, Damiani D, et al. Adrenocortical carcinoma: prognostic indices based on clinical and immunohistochemical markers. J Pediatr Endocrinol Metab 2005;18:347–53.10.1515/JPEM.2005.18.4.347Search in Google Scholar
32. Sbragia L, Sbragia L, Oliveira-Filho AG, Oliveira-Filho AG, Vassallo J, et al. Adrenocortical tumors in Brazilian children: immunohistochemical markers and prognostic factors. Arch Pathol Lab Med 2005;129:1127–31.10.5858/2005-129-1127-ATIBCISearch in Google Scholar
33. Bugg MF, Ribeiro RC, Roberson PK, Lloyd RV, Sandrini R, et al. Correlation of pathologic features with clinical outcome in pediatric adrenocortical neoplasia. A study of a Brazilian population. Brazilian Group for Treatment of Childhood Adrenocortical Tumors. Am J Clin Pathol 1994;101:625–9.10.1093/ajcp/101.5.625Search in Google Scholar PubMed
34. Chatterjee G, DasGupta S, Mukherjee G, Sengupta M, Roy P, et al. Usefulness of Wieneke criteria in assessing morphologic characteristics of adrenocortical tumors in children. Pediatr Surg Int 2015;31:563–71.10.1007/s00383-015-3708-xSearch in Google Scholar PubMed
35. Agrons GC, Lonergan GJ, Dickey GE, Perez-Monte JE. Adrenocortical neoplasms in children: radiologic-pathologic correlation. Radiographics 1999;19:989–1008.10.1148/radiographics.19.4.g99jl14989Search in Google Scholar PubMed
36. Beuschlein F, Weigel J, Saeger W, Kroiss M, Wild V, et al. Major prognostic role of ki67 in localized adrenocortical carcinoma after complete resection. J Clin Endocrinol Metab 2015;100:841–9.10.1210/jc.2014-3182Search in Google Scholar PubMed
37. Leite FA, Lira, RC, Fedatto PF, Antonini SR, Martinelli CE Jr, et al. Low expression of HLA-DRA, HLA-DPA1, and HLA-DPB1 is associated with poor prognosis in pediatric adrenocortical tumors (ACT). J Clin Oncol 1996;14:1526–31.Search in Google Scholar
38. Leal LF, Mermejo LM, Ramalho LZ, Martinelli CE, Yunes J, et al. Wnt/beta-catenin pathway deregulation in childhood adrenocortical tumors. J Clin Endocrinol Metab 2011;96:3106–14.10.1210/jc.2011-0363Search in Google Scholar PubMed
39. Custódio G, Komechen H, Figueiredo FR, Fachin ND, Pianovski MA, et al. Molecular epidemiology of adrenocortical tumors in southern Brazil. Mol Cell Endocrinol 2012;351:44–51.10.1016/j.mce.2011.10.019Search in Google Scholar PubMed
40. Antonini SR, Colli LM, Ferro L, Mermejo L, De Castro M. [Childhood adrenocortical tumors: from a clinical to a molecular approach]. Arq Bras Endocrinol Metab 2011;55:599–606.10.1590/S0004-27302011000800014Search in Google Scholar PubMed
41. Wasserman JD, Zambetti GP, Malkin D. Towards an understanding of the role of p53 in adrenocortical carcinogenesis. Mol Cell Endocrinol 2012;351:101–10.10.1016/j.mce.2011.09.010Search in Google Scholar PubMed PubMed Central
42. Herrmann LJ, Heinze B, Fassnacht M, Willenberg HS, Quinkler M, et al. TP53 germline mutations in adult patients with adrenocortical carcinoma. J Clin Endocrinol Metab 2012;97:476–85.10.1210/jc.2011-1982Search in Google Scholar PubMed
43. Wilkin F, Gagné N, Paquette J, Oligny LL, Deal C. Pediatric adrenocortical tumors: molecular events leading to insulin-like growth factor II gene overexpression. J Clin Endocrinol Metab 2000;85:2048–56.Search in Google Scholar
44. West AN, Neale GA, Pounds S, Figueredo BC, Galindo CR, et al. Gene expression profiling of childhood adrenocortical tumors. Cancer Res 2007;67:600–8.10.1158/0008-5472.CAN-06-3767Search in Google Scholar PubMed
45. Weksberg R, Smith AC, Squire J, Sadowski P. Beckwith-Wiedemann syndrome demonstrates a role for epigenetic control of normal development. Hum Mol Genet 2003;12 Spec No:R61–8.10.1093/hmg/ddg067Search in Google Scholar PubMed
46. Tobias E. Association of adrenocortical carcinoma with familial cancer susceptibility syndromes. Mol Cell Endocrinol 2012;351:66–70.10.1016/j.mce.2011.12.008Search in Google Scholar PubMed PubMed Central
47. Gaujoux S, Pinson S, Gimenez-Roqueplo AP, Amar L, Ragazzon B, et al. Inactivation of the APC gene is constant in adrenocortical tumors from patients with familial adenomatous polyposis but not frequent in sporadic adrenocortical cancers. Clin Cancer Res 2010;16:5133–41.10.1158/1078-0432.CCR-10-1497Search in Google Scholar PubMed
48. Park BK, Kim CK, Kim B, Lee JH. Comparison of delayed enhanced CT and chemical shift MR for evaluating adrenal masses. Radiology 2007;243:760–5.10.1148/radiol.2433051978Search in Google Scholar PubMed
49. Bilbey JH, McLoughlin RF, Kurkjian PS, Wilkins GE, Chan NH, et al. MR imaging of adrenal masses: value of chemical-shift imaging for distinguishing adenomas from other tumors. Am J Roentgenol 1995;164:637–44.10.2214/ajr.164.3.7863885Search in Google Scholar PubMed
50. Caoili EM, Korobkin M, Francis IR, Cohan RH, Platt JF, et al. Adrenal masses: characterization with combined unenhanced and delayed enhanced CT. Radiology 2002;222:629–33.10.1148/radiol.2223010766Search in Google Scholar PubMed
51. Boland GW, Dwamena BA, Jagtiani Sangwaiya M, Goehler AG, Blake MA, et al. Characterization of adrenal masses by using FDG PET: a systematic review and meta-analysis of diagnostic test performance. Radiology 2011;259:117–26.10.1148/radiol.11100569Search in Google Scholar PubMed
52. Boland GW, Blake MA, Holalkere NS, Hahn PF. PET/CT for the characterization of adrenal masses in patients with cancer: qualitative versus quantitative accuracy in 150 consecutive patients. Am J Roentgenol 2009;192:956–62.10.2214/AJR.08.1431Search in Google Scholar PubMed
53. Blake MA, Slattery JM, Kalra MK, Halpern EF, Fischman AJ, et al. Adrenal lesions: characterization with fused PET/CT image in patients with proved or suspected malignancy–initial experience. Radiology 2006;238:970–7.10.1148/radiol.2383042164Search in Google Scholar PubMed
54. Szolar DH, Korobkin M, Reittner P, Berghold A, Bauernhofer T, et al. Radiology and adrenal pheochromocytomas: mass and enhancement loss. Radiology 2005;234:479–85.10.1148/radiol.2342031876Search in Google Scholar PubMed
55. Slattery JM, Blake MA, Kalra MK, Misdraji J, Sweeney AT, et al. Adrenocortical carcinoma: contrast washout characteristics on CT. Am J Roentgenol 2006;187:97.10.2214/AJR.04.1751Search in Google Scholar PubMed
56. Blake MA, Karlra MK, Sweeney AY, Maher MM, Sahani DV, et al. Distinguishing benign from malignant adrenal masses: multi-detector row CT protocol with 10-min delay. Radiology 2006;238:578–85.10.1148/radiol.2382041514Search in Google Scholar PubMed
57. Jhaveri KS, Wong F, Ghai S, Haider MA. Comparison of CT histogram analysis and chemical shift MRI in the characterization of indeterminate adrenal nodules. Am J Roentgenol 2006;187:1303–8.10.2214/AJR.05.1022Search in Google Scholar PubMed
58. Hahn PF, Blake MA, Boland GW. Adrenal lesions: attenuation measurement differences between CT scanners. Radiology 2006;240:458–63.10.1148/radiol.2402042120Search in Google Scholar PubMed
59. Remer EM, Motta-Ramirez GA, Shepardson LB, Hamrahian AH, Herts BR. CT histogram analysis in pathologically proven adrenal masses. Am J Roentgenol 2006;187:191–6.10.2214/AJR.05.0179Search in Google Scholar PubMed
60. Pinto A, Scaglione M, Guidi G, Farina R, Acampora C, et al. Role of multidetector row computed tomography in the assessment of adrenal gland injuries. Eur J Radiol 2006;59:355–8.10.1016/j.ejrad.2006.04.029Search in Google Scholar PubMed
61. Park BK, Kim CK, Kim B, Choi JY. Comparison of delayed enhanced CT and 18F-FDG PET/CT in the evaluation of adrenal masses in oncology patients. J Comput Assist Tomogr 2007;31:550–6.10.1097/rct.0b013e31802fa8e1Search in Google Scholar PubMed
62. Jhaveri KS, Lad SV, Haider MA. Computed tomographic histogram analysis in the diagnosis of lipid-poor adenomas: comparison to adrenal washout computed tomography. J Comput Assist Tomogr 2007;31:513–8.10.1097/01.rct.0000250105.93423.a2Search in Google Scholar PubMed
63. Rescinito G, Zandrino F, Cittadini G, Santacroce E, Giasotto V, et al. Characterization of adrenal adenomas and metastases: correlation between unenhanced computed tomography and chemical shift magnetic resonance imaging. Acta Radiol 2006;47:71–6.10.1080/02841850500405193Search in Google Scholar PubMed
64. Ho LM, Paulson EK, Brady MJ, Wong TZ, Schindera ST. Lipid-poor adenomas on unenhanced CT: does histogram analysis increase sensitivity compared with a mean attenuation threshold? Am J Roentgenol 2008;191:234–8.10.2214/AJR.07.3150Search in Google Scholar PubMed
65. Yoh T, Hosono M, Komeya Y, Im SW, Ashikaga R, et al. Quantitative evaluation of norcholesterol scintigraphy, CT attenuation value, and chemical-shift MR imaging for characterizing adrenal adenomas. Ann Nucl Med 2008;22:513–9.10.1007/s12149-008-0143-2Search in Google Scholar PubMed
66. Song JH, Chaudhry FS, Mayo-Smith WW. The incidental adrenal mass on CT: prevalence of adrenal disease in 1049 consecutive adrenal masses in patients with no known malignancy. Am J Roentgenol 2008;190:1163–8.10.2214/AJR.07.2799Search in Google Scholar PubMed
67. Hennings J, Hellman P, Ahlstrom H, Sundin A. Computed tomography, magnetic resonance imaging and 11C-metomidate positron emission tomography for evaluation of adrenal incidentalomas. Eur J Radiol 2009;69:314–23.10.1016/j.ejrad.2007.10.024Search in Google Scholar PubMed
68. Čtvrtlík F, Heřman M, Študent V, Tichá V, Minařík J. Differential diagnosis of incidentally detected adrenal masses revealed on routine abdominal CT. Eur J Radiol 2009;69:243–52.10.1016/j.ejrad.2007.11.041Search in Google Scholar PubMed
69. Kamiyama T, Fukukura Y, Yoneyama T, Takumi K, Nakajo M. Combined use of diagnostic parameters of unenhanced and short 5-minute dynamic enhanced CT protocol. Radiology 2009;250:474–81.10.1148/radiol.2502080302Search in Google Scholar PubMed
70. Päivänsalo M, Lähde S, Merikanto J, Kallionen M. Computed tomography in primary and secondary adrenal tumours. Acta Radiol 2010;29:519–22.10.1177/028418518802900505Search in Google Scholar
71. Halefoglu AM, Bas N, Yasar A, Basak M. Differentiation of adrenal adenomas from nonadenomas using CT histogram analysis method: a prospective study. Eur J Radiol 2010;73:643–51.10.1016/j.ejrad.2008.12.010Search in Google Scholar PubMed
72. Sangwaiya MJ, Boland GW, Cronin CG, Blake MA, Halpern EF, et al. Genitourinary imaging incidental adrenal lesions: accuracy of characterization with contrast-enhanced Washout. Radiology 2010;256:504–10.10.1148/radiol.10091386Search in Google Scholar PubMed
73. Foti G, Faccioli N, Manfredi R, Mantovani W, Mucelli RP. Evaluation of relative wash-in ratio of adrenal lesions at early biphasic CT. Am J Roentgenol 2010;194:1484–91.10.2214/AJR.09.3636Search in Google Scholar PubMed
74. Gupta RT, Ho LM, Marin D, Boll DT, Barnhart HX, et al. Dual-energy CT for characterization of adrenal nodules: initial experience. Am J Roentgenol 2010;194:1479–83.10.2214/AJR.09.3476Search in Google Scholar PubMed
75. Qin HY, Sun HR, Li YJ, Shen BZ. Application of CT perfusion imaging to the histological differentiation of adrenal gland tumors. Eur J Radiol 2012;81:502–7.10.1016/j.ejrad.2010.12.072Search in Google Scholar PubMed
76. Zhang HM, Perrier ND, Grubbs EG, Sircar K, Ye ZX, et al. CT features and quantification of the characteristics of adrenocortical carcinomas on unenhanced and contrastenhanced studies. Clin Radiol 2012;67:38–46.10.1016/j.crad.2011.03.023Search in Google Scholar PubMed PubMed Central
77. Olsen H, Nordenstrom E, Bergenfelz A, Nyman U, Valdemarsson S, et al. Subclinical hypercortisolism and CT appearance in adrenal incidentalomas: a multicenter study from Southern Sweden. Endocrine 2012;42:164–73.10.1007/s12020-012-9622-2Search in Google Scholar PubMed
78. Foti G, Faccioli N, Mantovani W, Malleo G, Manfredi R, et al. Incidental adrenal lesions: accuracy of quadriphasic contrast enhanced computed tomography in distinguishing adenomas from nonadenomas. Eur J Radiol 2012;81:1742–50.10.1016/j.ejrad.2011.04.066Search in Google Scholar PubMed
79. Kumagae Y, Fukukura Y, Takumi K, Shindo T, Tateyama A, et al. Distinguishing adrenal adenomas from non-adenomas on dynamic enhanced CT: a comparison of 5 and 10 min delays after intravenous contrast medium injection. Clin Radiol 2013;68:696–703.10.1016/j.crad.2013.01.016Search in Google Scholar PubMed
80. Morgan DE, Weber AC, Lockhart ME, Weber TM, Fineberg NS, et al. Differentiation of high lipid content from low lipid content adrenal lesions using single-source rapid kilovolt (peak)-switching dual-energy multidetector CT. J Comput Assist Tomogr 2013;37:937–43.10.1097/RCT.0b013e3182aaf996Search in Google Scholar PubMed
81. Song JH, Grand DJ, Beland MD, Chang KJ, Machan JT, et al. Morphologic features of 211 adrenal masses at initial contrast-enhanced CT: can we differentiate benign from malignant lesions using imaging features alone? Am J Roentgenol 2013;201:1248–53.10.2214/AJR.12.10302Search in Google Scholar PubMed
82. Pennanen M, Raade M, Louhimo J, Sane T, Heiskanen I, et al. Adrenocortical tumours: high CT attenuation value correlates with eosinophilia but does not discriminate lipid-poor adenomas from malignancy. J Clin Pathol 2013;66:1076–80.10.1136/jclinpath-2013-201513Search in Google Scholar PubMed
83. Patel J, Davenport MS, Cohan RH, Caoili EM. Can established CT attenuation and washout criteria for adrenal adenoma accurately exclude pheochromocytoma? Am J Roentgenol 2013;201:122–7.10.2214/AJR.12.9620Search in Google Scholar PubMed
84. Khan M, Caoili EM, Davenport MS, Poznanski A, Francis IR, et al. CT imaging characteristics of oncocytic adrenal neoplasms (OANs): comparison with adrenocortical carcinomas. Abdom Imaging 2014;39:86–91.10.1007/s00261-013-0047-zSearch in Google Scholar PubMed
85. Mileto A, Nelson RC, Marin D, Roy Choudhury K, Ho LM. Dual-energy multidetector CT for the characterization of incidental adrenal nodules: diagnostic performance of contrast-enhanced material density analysis. Radiology 2015;274:445–54.10.1148/radiol.14140876Search in Google Scholar PubMed
86. Park SY, Park BK, Park JJ, Kim CK. CT sensitivities for large (≥3 cm) adrenal adenoma and cortical carcinoma. Abdom Imaging 2015;40:310–7.10.1007/s00261-014-0202-1Search in Google Scholar PubMed
87. Metser U, Miller E, Lerman H, Lievshitz G, Avital S, et al. 18F-FDG PET/CT in the evaluation of adrenal masses. J Nucl Med 2006;47:32–7.Search in Google Scholar
88. Jana S, Zhang T, Milstein DM, Isasi CR, Blaufox MD. FDG-PET and CT characterization of adrenal lesions in cancer patients. Eur J Nucl Med Mol Imaging 2006;33:29–35.10.1007/s00259-005-1915-8Search in Google Scholar PubMed
89. Han SJ, Kim TS, Jeon SW, Jeong SJ, Yun M, et al. Analysis of adrenal masses by 18F-FDG positron emission tomography scanning. Int J Clin Pract 2007;61:802–9.10.1111/j.1742-1241.2006.01220.xSearch in Google Scholar PubMed
90. Caoili EM, Korobkin M, Brown RK, Mackie G, Shulkin BL. Differentiating adrenal adenomas from nonadenomas using 18F-FDG PET/CT. Quantitative and qualitative evaluation. Acad Radiol 2007;14:468–75.10.1016/j.acra.2007.01.009Search in Google Scholar PubMed
91. Sung YM, Lee KS, Kim BT, Choi JY, Chung MJ, et al. 18F-FDG PET versus 18F-FDG PET/CT for adrenal gland lesion characterization: a comparison of diagnostic efficacy in lung cancer patients. Korean J Radiol 2008;9:19–28.10.3348/kjr.2008.9.1.19Search in Google Scholar PubMed PubMed Central
92. Okada M, Shimono T, Komeya Y, Ando R, Kagawa Y, et al. Adrenal masses: the value of additional fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in differentiating between benign and malignant lesions. Ann Nucl Med 2009;23:349–54.10.1007/s12149-009-0246-4Search in Google Scholar PubMed
93. Perri M, Erba P, Volterrani D, Guidoccio F, Lazzeri E, et al. Adrenal masses in patients with cancer: PET/CT characterization with combined CT histogram and standardized uptake value PET analysis. Am J Roentgenol 2011;197:209–16.10.2214/AJR.10.5342Search in Google Scholar PubMed
94. Watanabe H, Kanematsu M, Goshima S, Kondo H, Kawada H, et al. Adrenal-to-liver SUV ratio is the best parameter for differentiation of adrenal metastases from adenomas using 18F-FDG PET/CT. Ann Nucl Med 2013;27:648–53.10.1007/s12149-013-0730-8Search in Google Scholar PubMed
95. Evans PD, Miller CM, Marin D, Stinnett SS, Wong TZ, et al. FDG-PET/CT Characterization of Adrenal Nodules. Acad Radiol 2013;20:923–9.10.1016/j.acra.2013.02.010Search in Google Scholar PubMed
96. Park HJ, Kim SH, Jang KM, Lee SJ, Park MJ, et al. Differentiating hepatic abscess from malignant mimickers: value of diffusion-weighted imaging with an emphasis on the periphery of the lesion. J Magn Reson Imaging 2013;38:1333–41.10.1002/jmri.24112Search in Google Scholar PubMed
97. Takanami K, Kaneta T, Morimoto R, Satoh F, Nakamura Y, et al. Characterization of lipid-rich adrenal tumors by FDG PET/CT: are they hormone-secreting or not? Ann Nucl Med 2014;28: 45–53.10.1007/s12149-013-0793-6Search in Google Scholar PubMed
98. Park YS, Park KB, Kim KC. The value of adding 18F-FDG PET/CT to adrenal protocol CT for characterizing adrenal metastasis (≥10 mm) in oncologic patients. AJR 2014;202:153–60.10.2214/AJR.13.10873Search in Google Scholar PubMed
99. Kunikowska J, Matyskiel R, Toutounchi S, Grabowska-Derlatka L, Koperski L, et al. What parameters from F-18-FDG PET/CT are useful in evaluation of adrenal lesions? Eur J Nucl Med Mol Imaging 2014;41:2273–80.10.1007/s00259-014-2844-1Search in Google Scholar PubMed PubMed Central
100. Takeuchi S, Balachandran A, Habra MA, Phan AT, Bassett RL, et al. Impact of 18F-FDG PET/CT on the management of adrenocortical carcinoma: analysis of 106 patients. Eur J Nucl Med Mol Imaging 2014;41:2066–73.10.1007/s00259-014-2834-3Search in Google Scholar PubMed
101. Cistaro A, Niccoli Asabella A, Coppolino P, Quartuccio N, Altini C, et al. Diagnostic and prognostic value of 18F-FDG PET/CT in comparison with morphological imaging in primary adrenal gland malignancies – a multicenter experience. Hell J Nucl Med 2015;18:97–102.Search in Google Scholar
102. Maurea S, Imbriaco M, D’Angelillo M, Mollica C, Camera L, et al. Diagnostic accuracy of chemical-shift MR imaging to differentiate between adrenal adenomas and non adenoma adrenal lesions. Radiol Med 2006;111:674–86.10.1007/s11547-006-0065-9Search in Google Scholar PubMed
103. Savci G, Yazici Z, Sahin N, Akgöz S, Tuncel E. Value of chemical shift subtraction MRI in characterization of adrenal masses. Am J Roentgenol 2006;186:130–5.10.2214/AJR.04.1370Search in Google Scholar PubMed
104. Inan N, Arslan A, Akansel G, Anik Y, Balci NC, et al. Dynamic contrast enhanced MRI in the differential diagnosis of adrenal adenomas and malignant adrenal masses. Eur J Radiol 2008;65:154–62.10.1016/j.ejrad.2007.03.012Search in Google Scholar PubMed
105. Halefoglu AM, Yasar A, Bas N, Ozel A, Erturk ŞM, et al. Comparison of computed tomography histogram analysis and chemical-shift magnetic resonance imaging for adrenal mass characterization. Acta radiol 2009;50:1071–9.10.3109/02841850903207170Search in Google Scholar PubMed
106. Nakamura S, Namimoto T, Morita K, Utsunomiya D, Oda S, et al. Characterization of adrenal lesions using chemical shift MRI: comparison between 1.5 tesla and two echo time pair selection at 3.0 tesla MRI. J Magn Reson Imaging 2012;35:95–102.10.1002/jmri.22728Search in Google Scholar PubMed
107. Aksakal N, Şahbaz A, Özçınar B, Özemir A, Çağlayan K, et al. Nonfunctional adrenal lesions without loss of signal intensity on MRI: whose problem is it? The patient’s? The surgeon’s? Int J Surg 2013;11:169–72.10.1016/j.ijsu.2012.12.014Search in Google Scholar PubMed
108. Seo JM, Park BK, Park SY, Kim CK. Characterization of lipid-poor adrenal adenoma: chemical-shift MRI and washout CT. Am J Roentgenol 2014;202:1043–50.10.2214/AJR.13.11389Search in Google Scholar PubMed
109. Helck A, Hummel N, Meinel FG, Johnson T, Nikolaou K, et al. Can single-phase dual-energy CT reliably identify adrenal adenomas? Eur Radiol 2014;24:1636–42.10.1007/s00330-014-3192-zSearch in Google Scholar PubMed
110. Kilickesmez O, Inci E, Atilla S, Tasdelen N, Yetimoğlu B, et al. Diffusion-weighted imaging of the renal and adrenal lesions. J Comput Assist Tomogr 2009;33:828–33.10.1097/RCT.0b013e31819f1b83Search in Google Scholar PubMed
111. Tsushima Y, Takahashi-Taketomi A, Endo K. Diagnostic utility of diffusion-weighted MR imaging and apparent diffusion coefficient value for the diagnosis of adrenal tumors. J Magn Reson Imaging 2009;29:112–7.10.1002/jmri.21616Search in Google Scholar PubMed
112. Miller FH, Wang Y, McCarthy RJ, Yaghmai V, Merrick L, et al. Utility of diffusion-weighted MRI in characterization of adrenal lesions. Am J Roentgenol 2010;194:W179–85.10.2214/AJR.09.2891Search in Google Scholar PubMed
113. Sandrasegaran K, Patel AA, Ramaswamy R, Samuel VP, Northcutt BG, et al. Characterization of adrenal masses with diffusion-weighted imaging. Am J Roentgenol 2011;197:132–8.10.2214/AJR.10.4583Search in Google Scholar PubMed
114. Işik Y, Gürses B, Taşdelen N, Kiliçkesmez Ö, Firat Z, et al. Diffusion tensor imaging in the differentiation of adrenal adenomas and metastases. Diagnostic Interv Radiol 2012;18:189–94.Search in Google Scholar
115. Song J, Zhang C, Liu Q, Yu T, Jiang X, et al. Utility of chemical shift and diffusion-weighted imaging in characterization of hyperattenuating adrenal lesions at 3.0T. Eur J Radiol 2012;81:2137–43.10.1016/j.ejrad.2011.09.016Search in Google Scholar PubMed
116. Halefoglu AM, Altun I, Disli C, Ulusay SM, Ozel BD, et al. A prospective study on the utility of diffusion-weighted and quantitative chemical-shift magnetic resonance imaging in the distinction of adrenal adenomas and metastases. J Comput Assist Tomogr 2012;36:367–74.10.1097/RCT.0b013e3182597613Search in Google Scholar PubMed
117. Dong Y, Liu Q. Differentiation of malignant from benign pheochromocytomas with diffusion-weighted and dynamic. J Comp Assis Tomogr 2012;36:361–6.10.1097/RCT.0b013e31825975f8Search in Google Scholar PubMed
118. Ciçekçi M, Onur MR, Aydin AM, Gül Y, Ozkan Y, et al. The role of apparent diffusion coefficient values in differentiation between adrenal masses. Clin Imaging 2013;38:148–53.10.1016/j.clinimag.2013.11.003Search in Google Scholar PubMed
119. Hida T, Nishie A, Asayama Y, Ishigami K, Ushijima Y, et al. Apparent diffusion coefficient characteristics of various adrenal tumors. Magn Reson Med Sci 2014;13:183–9.10.2463/mrms.2013-0113Search in Google Scholar PubMed
120. Leroy-Willig A, Bittoun J, Luton JP, Louvel A, Lefevre JE, et al. In vivo MR spectroscopic imaging of the adrenal glands: distinction between adenomas and carcinomas larger than 15 mm based on lipid content. Am J Roentgenol 1989;153:771–3.10.2214/ajr.153.4.771Search in Google Scholar PubMed
121. Faria JF, Goldman SM, Szejnfeld J, Melo H, Kater C, et al. Adrenal masses: characterization with in vivo proton MR spectroscopy–initial experience. Radiology 2007;245:788–97.10.1148/radiol.2453061854Search in Google Scholar PubMed
122. Melo HJ, Goldman SM, Szejnfeld J, Faria JF, Huayllas MK, et al. Application of a protocol for magnetic resonance spectroscopy of adrenal glands: an experiment with over 100 cases. Radiol Bras 2014;47:333–41.10.1590/0100-3984.2013.1812Search in Google Scholar PubMed PubMed Central
123. Daneman A, Chan HS, Martin J. Adrenal carcinoma and adenoma in children: a review of 17 patients. Pediatr Radiol 1983;13:11–8.10.1007/BF00975660Search in Google Scholar PubMed
124. Davies RP, Lam AH. Adrenocortical neoplasm in children. Ultrasound appearance. J Ultrasound Med 1987;6: 325–8.10.7863/jum.1987.6.6.325Search in Google Scholar PubMed
125. Prando A, Wallace S, Marins JL, Pereira RM, de Oliveira ER. Sonographic findings of adrenal cortical carcinomas in children. Pediatr Radiol 1990;20:163–5.10.1007/BF02012962Search in Google Scholar PubMed
126. Hanson JA, Weber A, Reznek RH, Cotterill AM, Ross RJ, et al. Magnetic resonance imaging of adrenocortical adenomas in childhood: correlation with computed tomography and ultrasound. Pediatr Radiol 1996;26:794–9.10.1007/BF01396204Search in Google Scholar PubMed
127. Ribeiro J, Ribeiro RC, Fletcher BD. Imaging findings in pediatric adrenocortical carcinoma. Pediatr Radiol 2000;30:45–51.10.1007/s002470050013Search in Google Scholar PubMed
128. Martínez León MI, Romero Chaparro S, Weil Lara B, Domínguez Pinos MD, Ceres Ruiz L, et al. [Adrenocortical tumors in children: imaging adenomas and carcinomas]. Radiologia 2011;54:342–9.10.1016/j.rxeng.2011.02.002Search in Google Scholar
129. Flynt KA, Dillman JR, Davenport MS, Smith EA, Else T, et al. Pediatric adrenocortical neoplasms: can imaging reliably discriminate adenomas from carcinomas? Pediatr Radiol 2015;45:1160–8.10.1007/s00247-015-3308-xSearch in Google Scholar
130. Lee MJ, Hahn PF, Papanicolaou N, Egglin TK, Saini S, et al. Benign and malignant adrenal masses: CT distinction with attenuation coefficients, size, and observer analysis. Radiology 1991;179:415–8.10.1148/radiology.179.2.2014283Search in Google Scholar
131. Barnett CC Jr, Varma DG, El-Naggar AK, Dackiw AP, Porter GA, et al. Limitations of size as a criterion in the evaluation of adrenal tumors. Surgery 2000;128:973–83.10.1067/msy.2000.110237Search in Google Scholar
132. Peña CS, Boland GW, Hahn PF, Lee MJ, Mueller PR. Characterization of indeterminate (lipid-poor) adrenal masses: use of washout characteristics at contrast-enhanced CT. Radiology 2000;217:798–802.10.1148/radiology.217.3.r00dc29798Search in Google Scholar
133. Korobkin M, Brodeur FJ, Yutzy GG, Francis IR, Quint LE, et al. Differentiation of adrenal adenomas from nonadenomas using CT attenuation values. Am J Roentgenol 1996;166:531–6.10.2214/ajr.166.3.8623622Search in Google Scholar
134. Fishman EK, Deutch BM, Hartman DS, Goldman SM, Zerhouni EA, et al. Primary adrenocortical carcinoma: CT evaluation with clinical correlation. Am J Roentgenol 1987;148:531–5.10.2214/ajr.148.3.531Search in Google Scholar
135. Nogueira TM, Lirov R, Caoili EM, Lerario AM, Miller BS, et al. Radiographic characteristics of adrenal masses preceding the diagnosis of adrenocortical cancer. Horm Cancer 2015;6:176–81.10.1007/s12672-015-0225-2Search in Google Scholar
136. Ng L, Libertino JM. Adrenocortical carcinoma: diagnosis, evaluation and treatment. J Urol 2003;169:5–11.10.1016/S0022-5347(05)64023-2Search in Google Scholar
137. Nagase LL, Semelka RC, Armao D. Adrenal glands. In: Semelka RC, editor. Abdominal-pelvic MRI. New York, NY: Wiley-Liss, 2002:695–740.Search in Google Scholar
138. Rodacki K, Ramalho M, Dale BM, Battisti S, de Campos RO, et al. Combined chemical shift imaging with early dynamic serial gadolinium-enhanced MRI in the characterization of adrenal lesions. Am J Roentgenol 2014;203:99–106.10.2214/AJR.13.11731Search in Google Scholar PubMed
139. Korobkin M, Brodeur FJ, Francis IR, Quint LE, Dunnick NR, et al. CT time-attenuation curves of adrenal nonadenomas. Am J Roentgenol 1998;170:747–52.10.2214/ajr.170.3.9490968Search in Google Scholar PubMed
140. Herr K, Muglia VF, Westphalen AC. Imaginologia das lesões das glândulas adrenais. Radiol Bras 2014;47:228–39.10.1590/0100-3984.2013.1762Search in Google Scholar PubMed PubMed Central
141. Haider MA, Ghai S, Jhaveri K, Lockwood G. Chemical shift MR imaging of hyperattenuating (>10 HU) adrenal masses: does it still have a role? Radiology 2004;231:711–6.10.1148/radiol.2313030676Search in Google Scholar PubMed
142. Hussain S, Belldegrun A, Seltzer SE. Differentiation of malignant from benign adrenal masses: predictive indices on computed tomography. Am J Roentgenol 1985;144:61–5.10.2214/ajr.144.1.61Search in Google Scholar PubMed
143. Schlund JF, Kenney PJ, Brown ED, Ascher SM, Brown JJ, et al. Adrenocortical carcinoma: MR imaging appearance with current techniques. J Magn Reson Imaging 1995;5:171–4.10.1002/jmri.1880050211Search in Google Scholar PubMed
144. Li G, Xu P, Pan X, Qin H, Chen Y. The effect of age on apparent diffusion coefficient values in normal spleen: a preliminary study. Clin Radiol 2014;69:e165–7.10.1016/j.crad.2013.11.017Search in Google Scholar PubMed
145. Yoshida S, Masuda H, Ishii C, Saito K, Kawakami S, et al. Initial experience of functional imaging of upper urinary tract neoplasm by diffusion-weighted magnetic resonance imaging. Int J Urol 2008;15:140–3.10.1111/j.1442-2042.2007.01950.xSearch in Google Scholar PubMed
146. Zhang J, Jing H, Han X, Huang Z, Cao Z, et al. Diffusion-weighted imaging of prostate cancer on 3T MR: relationship between apparent diffusion coefficient values and Ki-67 expression. Acad Radiol 2013;20:1535–41.10.1016/j.acra.2013.09.007Search in Google Scholar PubMed
147. Shinya S, Sasaki T, Nakagawa Y, Guiquing Z, Yamamoto F, et al. The usefulness of diffusion-weighted imaging (DWI) for the detection of gastric cancer. Hepatogastroenterology 2007;54:1378–81.Search in Google Scholar
148. Kobayashi S, Koga F, Kajino K, Yoshita S, Ishii C, et al. Apparent diffusion coefficient value reflects invasive and proliferative potential of bladder cancer. J Magn Reson Imaging 2014;39:172–8.10.1002/jmri.24148Search in Google Scholar PubMed
149. Donati OF, Mazaheri Y, Afaq A, Vargas HA, Zheng J, et al. Prostate cancer aggressiveness: assessment with whole-lesion histogram analysis of the apparent. Radiology 2014;271:143–52.10.1148/radiol.13130973Search in Google Scholar PubMed
150. Teixeira SR, Elias PL, Melo AF Jr, et al. Apparent diffusion coefficient (ADC) of the normal adrenal glands. Radiologia Brasileira 2016;49:363–8.10.1590/0100-3984.2015.0045Search in Google Scholar
151. Tsushima Y, Ishizaka H, Matsumoto M. Adrenal masses: differentiation with chemical shift, fast low-angle shot MR imaging. Radiology 1993;186:705–9.10.1148/radiology.186.3.8430178Search in Google Scholar
152. Leroy-Willig A, Roucayrol JC, Luton JP, Courtieu J, Niesenbaum N, et al. In vitro adrenal cortex lesions characterization by NMR spectroscopy. Magn Reson Imaging 1987;5:339–44.10.1016/0730-725X(87)90123-8Search in Google Scholar
153. Hamper UM, Fishman EK, Hartman DS, Roberts JL, Sanders RC. Primary adrenocortical carcinoma: sonographic evaluation with clinical and pathologic correlation in 26 patients. Am J Roentgenol 1987;148:915–9.10.2214/ajr.148.5.915Search in Google Scholar PubMed
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