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 < 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 SUVratio at cut-off value>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.