- Provide an overview of various adrenal neoplasms,
with special focus on their radiological characteristics; - Present valid recommendations for appropriate management of adrenal incidental mass,
based on patient characteristics and imaging findings.
Due to advance and widespread use of imaging modalities,
incidental adrenal nodules are detected with increasing frequency nowadays.
Many of these lesions are benign,
mostly adenomas; however,
the possibility of malignant potential also exists and can not be ignored.
For this reason,
it’s essential to select cases which warrant further evaluation or intervention from those that should be left alone.
Thus radiological evaluation has a fundamental role in diagnosis and management of adrenal...
Findings and procedure details
IMAGING TECHNIQUES - Computed tomography (CT) CT is commonly the primary modality to detect and characterize adrenal masses. A dedicated adrenal CT protocol include the densitometry of the mass on noncontrast CT scans.
Attenuation values at unenhanced imaging: <10 Hounsfield units (HU): characteristic of a benign adrenal mass.
No further investigation is neccessary.It’s considered diagnostic of adenoma. >10 HU: perform an enhanced CT imaging at 60 seconds and 15 minutes after intravenous...
Adrenal masses are increasingly detected incidentally,
and radiology has a clear role in diagnosis and management of these lesions.
A proper diagnostic and standardized approach is imperative not only to select cases which need treatment,
but also to avoid unnecessary follow-up,
biopsy or surgery in benign entities.
- William W.,
Management of Incidental Adrenal Masses: A White Paper of the ACR Incidental Findings Committee.
J Am Coll Radiol 2017;14:1038-1044. - Nicola Schieda,
Update on CT and MRI of Adrenal Nodules.
AJR 2017; 208:1206–1217. -Jung-Min Lee,
Clinical Guidelines for the Management of Adrenal Incidentaloma.
Endocrinol Metab 2017; 32:200-218. - MartinFassnacht,
Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in...