Abstract:
Background and Objectives: Primary adrenal tumors (AT) are a heterogeneous group of neoplasms due to their functional heterogeneity, which results in the diverse clinical presentation of these tumors. The purpose of this study was to examine cross-sectional imaging characteristics using multi-detector computed tomography (MDCT) to provide insight into the lesion characterization and functional status of these tumors. The radionuclide imaging using Technetium-99m radiolabeled hydrazinonicotinylacid-d-phenylalanyl1-tyrosine3-octreotide (99mTc-HYNIC-TOC), was also used in the diagnostic evaluation of these tumors. Materials and Methods: This cross-sectional study included 50 patients with confirmed diagnoses of AT (21 hormone-secreting and 29 non-functional) at the University Clinical Center, Kragujevac, Serbia, during the 2019-2022 year period. The morphological and dynamic characteristics using MDCT were performed, using qualitative, semi-quantitative, and quantitative analysis. Absolute washout (APW) and relative washout (RPW) values were also calculated. A semi-quantitative analysis of all visual findings with 99mTc-HYNIC-TOC was performed to compare the tumor to non-tumor tracer uptake. Results: A statistically significant difference was found in the MDCT values in the native phase (p < 0.05), the venous phase (p < 0.05), and the delayed phase (p < 0.001) to detect the existence of adrenal tumors. Most of these functional adrenocortical lesions (n = 44) can be differentiated using the delayed phase (p < 0.05), absolute percentage washout (APW) (p < 0.05), and relative percentage washout (RPW) (p < 0.001). Furthermore, 99mTc-HYNIC-TOC could have a high diagnostic yield to detect adrenal tumor existence (p < 0.001). There is a positive correlation between radionuclide imaging scan and APW to detect all AT (p < 0.01) and adrenocortical adenomas as well (p < 0.01). Conclusions: The results can be very helpful in a diagnostic algorithm to quickly and precisely diagnose the expansive processes of the adrenal glands, as well as to learn about the advantages and limitations of the mentioned imaging modalities.
摘要:
背景与目的:原发性肾上腺肿瘤(AT)由于其功能异质性,是一类异质性肿瘤,这导致这些肿瘤的不同临床表现。这项研究的目的是使用多探测器计算机断层扫描(MDCT)检查横截面成像特征,以深入了解这些肿瘤的病变特征和功能状态。使用99m放射性标记的肼基烟酸-d-苯丙氨酰1-酪氨酸3-奥曲肽(99mTc-HYNIC-TOC)进行放射性核素成像,也用于这些肿瘤的诊断评估。材料和方法:这项横断面研究包括在大学临床中心确认诊断为AT的50例患者(21个激素分泌和29个非功能性),克拉古耶瓦茨,塞尔维亚,在2019-2022年期间。使用MDCT进行了形态和动态特征,使用定性的,半定量,和定量分析。还计算了绝对洗脱(APW)和相对洗脱(RPW)值。使用99mTc-HYNIC-TOC对所有视觉发现进行半定量分析,以比较肿瘤与非肿瘤示踪剂的摄取。结果:在自然相中发现MDCT值具有统计学意义(p<0.05),静脉期(p<0.05),和延迟期(p<0.001)检测肾上腺肿瘤的存在。大多数这些功能性肾上腺皮质病变(n=44)可以使用延迟期(p<0.05)进行区分,绝对冲洗百分比(APW)(p<0.05),和相对冲洗百分比(RPW)(p<0.001)。此外,99mTc-HYNIC-TOC对肾上腺肿瘤的存在具有较高的诊断率(p<0.001)。放射性核素显像扫描与APW检测所有AT(p<0.01)和肾上腺皮质腺瘤(p<0.01)之间呈正相关。结论:该结果对于快速,准确地诊断肾上腺的扩张过程的诊断算法非常有帮助。以及了解上述成像模式的优点和局限性。