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This version published online on April 18, 2006
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-2612
A more recent version of this article appeared on July 1, 2006
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Submitted on December 2, 2005
Accepted on April 6, 2006

USE OF [18F]FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY IN EVALUATING LOCALLY RECURRENT AND METASTATIC ADRENOCORTICAL CARCINOMA

Gavin C. Mackie MD, Barry L. Shulkin MD*, Raul C. Ribeiro MD, Francis P. Worden MD, Paul G. Gauger MD, Rajen J. Mody MD, Len P. Connolly MD, Ghada Kunter MD, Carlos Rodriguez-Galindo MD, Jerold W. Wallis MD, Craig A. Hurwitz MD, and David E. Schteingart MD

Department of Radiology, Division of Nuclear Medicine (GCM, BLS); Department of Internal Medicine, Divisions of Hematology-Oncology (FPW) and Endocrinology and Metabolism (DES); Department of Surgery (PGG); and Department of Pediatrics and Communicable Diseases (RJM), University of Michigan Medical Center, Ann Arbor, MI; Departments of Radiological Sciences (BLS) and Hematology-Oncology (RCB, CGR), St. Jude Children's Research Hospital, Memphis, TN; Department of Radiology (LPC), Children's Hospital, Boston, MA; Department of Pediatrics (CAH), Maine Medical Center, Portland, ME; Departments of Pediatrics (GK) and Radiology (JAW), Washington University School of Medicine, St. Louis, MO

* To whom correspondence should be addressed. E-mail: Barry.shulkin{at}stjude.org.

1. Context. Adrenocortical carcinomas are uncommon, and their evaluation by [18F]fluorodeoxyglucose positron emission tomography (FDG PET) has not been well evaluated.

2. Objective. The purpose of this study was to examine the potential utility of FDG PET in the detection of recurrent or metastatic adrenocortical carcinoma.

3. Design. In patients with known adrenocortical carcinoma who underwent FDG-PET imaging for suspected recurrence or metastasis, FDG activity was compared with other imaging findings, clinical features, and the presence or absence of disease as confirmed by resection, biopsy, or clinical follow-up.

4. Setting. Four tertiary referral centers.

5. Patients or Other Participants. Twelve patients (10 females and 2 males 5 to 71 yr of age) were evaluated.

6. Main Outcome Measure(s). The main outcome measures were FDG activity, other imaging findings, and clinical features.

7. Results. Abnormal FDG uptake correctly indicated tumor recurrence in 10 patients. One patient with no abnormal FDG activity had a morphologic abnormality subsequently proven to be post-operative scar. Two patients, one with very small pulmonary lesions and one with a hepatic metastasis had false negative findings.

8. Conclusions. Most adrenocortical carcinomas accumulate and retain FDG and thus can be visualized by PET. However, false negative findings are possible, especially with very small lesions.
Key words: 18F-fluorodeoxyglucose • positron emission tomography • adrenal • cancer




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[Abstract] [Full Text] [PDF]


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