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Vol. 39. Issue 6.
Pages 393-403 (November - December 2020)
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Vol. 39. Issue 6.
Pages 393-403 (November - December 2020)
Continuing Education
Functional imaging studies of the adrenal cortex
Estudios de imagen funcional de la corteza adrenal
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S. Prado-Wohlwend, by the SEMNIM Endocrinology Working Group
Servicio de Medicina Nuclear, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Tables (5)
Table 1. Classification of adrenal lesions based on their malignant potential and localization.
Table 2. Principal indications of nuclear medicine studies in corticoadrenal imaging.
Table 3. Drugs which interfere with 131I-NP59 and their mechanism of action.
Table 4. Adapted from Shapiro et al.9 Protocols of acquisition of 131I-NP59 scintigraphy.
Table 5. Characteristics of the principal adrenal lesions in CT, MR and 18F-FDG PET/CT.18,23
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Abstract

The rising number of high-resolution imaging scans has increased the adrenal lesions detection, which require a differential diagnosis. Currently, the most commonly used scans are CT and MRI, but these are sometimes not very specific. In these cases, nuclear medicine scans with [131I]I-norcolesterol, [11C] C-metomidate and [18F] fludeoxyglucose help to differentiate benign vs. malignant lesions, to lateralize the involvement in hypersecretion disease, as well as to guide the therapeutic strategy in both unilateral and bilateral lesions.

Keywords:
Adrenal cortex
NP59
18F-FDG PET/CT
Hypercortisolism
Hyperaldosteronism
Adrenal incidentaloma
Resumen

El aumento en el número de exploraciones de imagen de alta resolución ha incrementado la detección de lesiones adrenales, que precisan un diagnóstico diferencial. En la actualidad las exploraciones más utilizadas son la TC y la RM, pero estas en ocasiones son poco específicas, por lo que las exploraciones de medicina nuclear con [131I]I-norcolesterol, [11C]C-metomidato y [18F]fludeoxiglucosa ayudan a diferenciar entre benignidad y malignidad, a lateralizar la afectación en caso de hipersecreción, y a orientar la estrategia terapéutica tanto en las lesiones unilaterales como bilaterales.

Palabras clave:
Corteza adrenal
NP59
18F-FDG PET/TC
Hipercortisolismo
Hiperaldosteronismo
Incidentaloma adrenal

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