DOI: 10.1148/rg.266065057
Integrated PET-CT for the Characterization of Adrenal Gland Lesions in Cancer Patients: Diagnostic Efficacy and Interpretation Pitfalls1
Semin Chong, MD,
Kyung Soo Lee, MD,
Ha Young Kim, MD,
Yoon Kyung Kim, MD,
Byung-Tae Kim, MD,
Myung Jin Chung, MD,
Chin A Yi, MD and
Ghee Young Kwon, MD
1 From the Department of Radiology and Center for Imaging Science (S.C., K.S.L., H.Y.K., Y.K.K., M.J.C., C.A.Y.), the Department of Nuclear Medicine (B.T.K.), and the Department of Pathology (G.Y.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, South Korea. Presented as an education exhibit at the 2005 RSNA Annual Meeting. Received April 6, 2006; revision requested May 15 and received May 30; accepted May 31. All authors have no financial relationships to disclose.
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Figure 1a. Metastatic adrenal mass from lung adenocarcinoma in a 52-year-old man. (a) Transverse contrast material–enhanced abdominal CT scan shows a 10-cm mass with central low attenuation (arrows) in the left adrenal gland. (b) Integrated PET-CT scan shows increased FDG uptake (maximum standardized uptake value [SUV], 12.8) in the left adrenal gland (arrows). (c) Photograph of the adrenonephrectomy specimen shows a large, well-defined, yellowish adrenal mass (arrows) superior to the left kidney (K).
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Figure 1b. Metastatic adrenal mass from lung adenocarcinoma in a 52-year-old man. (a) Transverse contrast material–enhanced abdominal CT scan shows a 10-cm mass with central low attenuation (arrows) in the left adrenal gland. (b) Integrated PET-CT scan shows increased FDG uptake (maximum standardized uptake value [SUV], 12.8) in the left adrenal gland (arrows). (c) Photograph of the adrenonephrectomy specimen shows a large, well-defined, yellowish adrenal mass (arrows) superior to the left kidney (K).
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Figure 1c. Metastatic adrenal mass from lung adenocarcinoma in a 52-year-old man. (a) Transverse contrast material–enhanced abdominal CT scan shows a 10-cm mass with central low attenuation (arrows) in the left adrenal gland. (b) Integrated PET-CT scan shows increased FDG uptake (maximum standardized uptake value [SUV], 12.8) in the left adrenal gland (arrows). (c) Photograph of the adrenonephrectomy specimen shows a large, well-defined, yellowish adrenal mass (arrows) superior to the left kidney (K).
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Figure 2a. Adrenal adenoma in a 50-year-old man with lung adenocarcinoma. (a) Transverse unenhanced CT scan shows a 29-mm lesion with homogeneous low attenuation of –8 HU (arrow) in the left adrenal gland, findings that suggest a fat-containing adenoma. (b) Integrated PET-CT scan shows little FDG uptake in the lesion (arrow), a finding that is consistent with a benign lesion. The lesion did indeed prove to be benign, showing no interval growth over a period of more than 12 months.
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Figure 2b. Adrenal adenoma in a 50-year-old man with lung adenocarcinoma. (a) Transverse unenhanced CT scan shows a 29-mm lesion with homogeneous low attenuation of –8 HU (arrow) in the left adrenal gland, findings that suggest a fat-containing adenoma. (b) Integrated PET-CT scan shows little FDG uptake in the lesion (arrow), a finding that is consistent with a benign lesion. The lesion did indeed prove to be benign, showing no interval growth over a period of more than 12 months.
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Figure 3a. Adrenal adenoma in a 60-year-old man with non–small cell lung cancer. (a, b) Dynamic contrast-enhanced early-phase (a) and delayed-phase (b) adrenal CT scans show a 34-mm ovoid mass (arrow) in the left adrenal gland. The calculated percentage washout was 68%, a finding that suggested adrenal adenoma. (c) Integrated PET-CT scan shows little FDG uptake in the mass (arrow) (maximum SUV, 2.1), a finding that helped confirm a benign adrenal lesion. The lesion showed no interval growth over a period of more than 12 months (cf Fig 2).
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Figure 3b. Adrenal adenoma in a 60-year-old man with non–small cell lung cancer. (a, b) Dynamic contrast-enhanced early-phase (a) and delayed-phase (b) adrenal CT scans show a 34-mm ovoid mass (arrow) in the left adrenal gland. The calculated percentage washout was 68%, a finding that suggested adrenal adenoma. (c) Integrated PET-CT scan shows little FDG uptake in the mass (arrow) (maximum SUV, 2.1), a finding that helped confirm a benign adrenal lesion. The lesion showed no interval growth over a period of more than 12 months (cf Fig 2).
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Figure 3c. Adrenal adenoma in a 60-year-old man with non–small cell lung cancer. (a, b) Dynamic contrast-enhanced early-phase (a) and delayed-phase (b) adrenal CT scans show a 34-mm ovoid mass (arrow) in the left adrenal gland. The calculated percentage washout was 68%, a finding that suggested adrenal adenoma. (c) Integrated PET-CT scan shows little FDG uptake in the mass (arrow) (maximum SUV, 2.1), a finding that helped confirm a benign adrenal lesion. The lesion showed no interval growth over a period of more than 12 months (cf Fig 2).
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Figure 4a. Metastatic adrenal nodule from renal cell carcinoma in a 61-year-old man. (a, b) Dynamic contrast-enhanced early-phase (a) and delayed-phase (b) adrenal CT scans show an inhomogeneous small nodule (arrow) in the right adrenal gland. The calculated absolute percentage washout was 49%, a finding that suggested a metastatic nodule. (c) Integrated PET-CT scan shows increased FDG uptake (maximum SUV, 4.6) in the right adrenal gland (arrow), a finding that is consistent with a malignant lesion. (d) Photomicrograph (original magnification, x100; hematoxylin-eosin [H-E] stain) of the adrenalectomy specimen shows malignant cells of the adrenal gland identical to those of hypernephroma.
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Figure 4b. Metastatic adrenal nodule from renal cell carcinoma in a 61-year-old man. (a, b) Dynamic contrast-enhanced early-phase (a) and delayed-phase (b) adrenal CT scans show an inhomogeneous small nodule (arrow) in the right adrenal gland. The calculated absolute percentage washout was 49%, a finding that suggested a metastatic nodule. (c) Integrated PET-CT scan shows increased FDG uptake (maximum SUV, 4.6) in the right adrenal gland (arrow), a finding that is consistent with a malignant lesion. (d) Photomicrograph (original magnification, x100; hematoxylin-eosin [H-E] stain) of the adrenalectomy specimen shows malignant cells of the adrenal gland identical to those of hypernephroma.
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Figure 4c. Metastatic adrenal nodule from renal cell carcinoma in a 61-year-old man. (a, b) Dynamic contrast-enhanced early-phase (a) and delayed-phase (b) adrenal CT scans show an inhomogeneous small nodule (arrow) in the right adrenal gland. The calculated absolute percentage washout was 49%, a finding that suggested a metastatic nodule. (c) Integrated PET-CT scan shows increased FDG uptake (maximum SUV, 4.6) in the right adrenal gland (arrow), a finding that is consistent with a malignant lesion. (d) Photomicrograph (original magnification, x100; hematoxylin-eosin [H-E] stain) of the adrenalectomy specimen shows malignant cells of the adrenal gland identical to those of hypernephroma.
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Figure 4d. Metastatic adrenal nodule from renal cell carcinoma in a 61-year-old man. (a, b) Dynamic contrast-enhanced early-phase (a) and delayed-phase (b) adrenal CT scans show an inhomogeneous small nodule (arrow) in the right adrenal gland. The calculated absolute percentage washout was 49%, a finding that suggested a metastatic nodule. (c) Integrated PET-CT scan shows increased FDG uptake (maximum SUV, 4.6) in the right adrenal gland (arrow), a finding that is consistent with a malignant lesion. (d) Photomicrograph (original magnification, x100; hematoxylin-eosin [H-E] stain) of the adrenalectomy specimen shows malignant cells of the adrenal gland identical to those of hypernephroma.
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Figure 5a. Metastatic adrenal nodule from ovarian cancer in a 56-year-old woman. (a) Transverse contrast-enhanced CT scan shows a homogeneously enhancing nodule (arrow) in the left adrenal gland. (b, c) Transverse chemical shift in-phase (b) and out-of-phase (c) MR images show no signal intensity change in the nodule (arrow) between phases. (d) Integrated PET-CT scan shows increased FDG uptake (maximum SUV, 5.2) in the left adrenal gland (arrow), a finding that is consistent with a malignant lesion.
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Figure 5b. Metastatic adrenal nodule from ovarian cancer in a 56-year-old woman. (a) Transverse contrast-enhanced CT scan shows a homogeneously enhancing nodule (arrow) in the left adrenal gland. (b, c) Transverse chemical shift in-phase (b) and out-of-phase (c) MR images show no signal intensity change in the nodule (arrow) between phases. (d) Integrated PET-CT scan shows increased FDG uptake (maximum SUV, 5.2) in the left adrenal gland (arrow), a finding that is consistent with a malignant lesion.
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Figure 5c. Metastatic adrenal nodule from ovarian cancer in a 56-year-old woman. (a) Transverse contrast-enhanced CT scan shows a homogeneously enhancing nodule (arrow) in the left adrenal gland. (b, c) Transverse chemical shift in-phase (b) and out-of-phase (c) MR images show no signal intensity change in the nodule (arrow) between phases. (d) Integrated PET-CT scan shows increased FDG uptake (maximum SUV, 5.2) in the left adrenal gland (arrow), a finding that is consistent with a malignant lesion.
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Figure 5d. Metastatic adrenal nodule from ovarian cancer in a 56-year-old woman. (a) Transverse contrast-enhanced CT scan shows a homogeneously enhancing nodule (arrow) in the left adrenal gland. (b, c) Transverse chemical shift in-phase (b) and out-of-phase (c) MR images show no signal intensity change in the nodule (arrow) between phases. (d) Integrated PET-CT scan shows increased FDG uptake (maximum SUV, 5.2) in the left adrenal gland (arrow), a finding that is consistent with a malignant lesion.
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Figure 6a. Metastatic adrenal nodule from gastric cancer in a 61-year-old man. (a) PET scan demonstrates greater FDG uptake (maximum SUV, 5.7) in the left adrenal gland (arrow) than in the liver. (b) Photomicrograph (original magnification, x100; H-E stain) of the pathologic specimen shows malignant cells in the adrenal gland identical to those of gastric cancer.
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Figure 6b. Metastatic adrenal nodule from gastric cancer in a 61-year-old man. (a) PET scan demonstrates greater FDG uptake (maximum SUV, 5.7) in the left adrenal gland (arrow) than in the liver. (b) Photomicrograph (original magnification, x100; H-E stain) of the pathologic specimen shows malignant cells in the adrenal gland identical to those of gastric cancer.
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Figure 7a. False-negative adrenal nodule at integrated PET-CT performed in a 59-year-old man with lung adenocarcinoma with a predominantly bronchioloalveolar carcinoma component. (a) Transverse contrast-enhanced CT scan shows a 15-mm ovoid nodule (arrow) in the right adrenal gland. (b, c) Transverse chemical shift in-phase (b) and out-of-phase (c) MR images show no signal intensity change in the nodule (arrow) between phases, a finding that indicates a high probability of metastasis. (d) Integrated PET-CT scan shows little FDG uptake (maximum SUV, 1.7) in the nodule (arrow), a finding that suggests a benign lesion. (e) Photograph of the right adrenalectomy specimen shows a solid, whitish, ovoid adrenal lesion (arrow). (f) Photomicrograph (original magnification, x100; H-E stain) of the specimen shows a metastatic lesion from lung adenocarcinoma with a predominantly bronchioloalveolar carcinoma component.
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Figure 7b. False-negative adrenal nodule at integrated PET-CT performed in a 59-year-old man with lung adenocarcinoma with a predominantly bronchioloalveolar carcinoma component. (a) Transverse contrast-enhanced CT scan shows a 15-mm ovoid nodule (arrow) in the right adrenal gland. (b, c) Transverse chemical shift in-phase (b) and out-of-phase (c) MR images show no signal intensity change in the nodule (arrow) between phases, a finding that indicates a high probability of metastasis. (d) Integrated PET-CT scan shows little FDG uptake (maximum SUV, 1.7) in the nodule (arrow), a finding that suggests a benign lesion. (e) Photograph of the right adrenalectomy specimen shows a solid, whitish, ovoid adrenal lesion (arrow). (f) Photomicrograph (original magnification, x100; H-E stain) of the specimen shows a metastatic lesion from lung adenocarcinoma with a predominantly bronchioloalveolar carcinoma component.
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Figure 7c. False-negative adrenal nodule at integrated PET-CT performed in a 59-year-old man with lung adenocarcinoma with a predominantly bronchioloalveolar carcinoma component. (a) Transverse contrast-enhanced CT scan shows a 15-mm ovoid nodule (arrow) in the right adrenal gland. (b, c) Transverse chemical shift in-phase (b) and out-of-phase (c) MR images show no signal intensity change in the nodule (arrow) between phases, a finding that indicates a high probability of metastasis. (d) Integrated PET-CT scan shows little FDG uptake (maximum SUV, 1.7) in the nodule (arrow), a finding that suggests a benign lesion. (e) Photograph of the right adrenalectomy specimen shows a solid, whitish, ovoid adrenal lesion (arrow). (f) Photomicrograph (original magnification, x100; H-E stain) of the specimen shows a metastatic lesion from lung adenocarcinoma with a predominantly bronchioloalveolar carcinoma component.
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Figure 7d. False-negative adrenal nodule at integrated PET-CT performed in a 59-year-old man with lung adenocarcinoma with a predominantly bronchioloalveolar carcinoma component. (a) Transverse contrast-enhanced CT scan shows a 15-mm ovoid nodule (arrow) in the right adrenal gland. (b, c) Transverse chemical shift in-phase (b) and out-of-phase (c) MR images show no signal intensity change in the nodule (arrow) between phases, a finding that indicates a high probability of metastasis. (d) Integrated PET-CT scan shows little FDG uptake (maximum SUV, 1.7) in the nodule (arrow), a finding that suggests a benign lesion. (e) Photograph of the right adrenalectomy specimen shows a solid, whitish, ovoid adrenal lesion (arrow). (f) Photomicrograph (original magnification, x100; H-E stain) of the specimen shows a metastatic lesion from lung adenocarcinoma with a predominantly bronchioloalveolar carcinoma component.
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Figure 7e. False-negative adrenal nodule at integrated PET-CT performed in a 59-year-old man with lung adenocarcinoma with a predominantly bronchioloalveolar carcinoma component. (a) Transverse contrast-enhanced CT scan shows a 15-mm ovoid nodule (arrow) in the right adrenal gland. (b, c) Transverse chemical shift in-phase (b) and out-of-phase (c) MR images show no signal intensity change in the nodule (arrow) between phases, a finding that indicates a high probability of metastasis. (d) Integrated PET-CT scan shows little FDG uptake (maximum SUV, 1.7) in the nodule (arrow), a finding that suggests a benign lesion. (e) Photograph of the right adrenalectomy specimen shows a solid, whitish, ovoid adrenal lesion (arrow). (f) Photomicrograph (original magnification, x100; H-E stain) of the specimen shows a metastatic lesion from lung adenocarcinoma with a predominantly bronchioloalveolar carcinoma component.
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Figure 7f. False-negative adrenal nodule at integrated PET-CT performed in a 59-year-old man with lung adenocarcinoma with a predominantly bronchioloalveolar carcinoma component. (a) Transverse contrast-enhanced CT scan shows a 15-mm ovoid nodule (arrow) in the right adrenal gland. (b, c) Transverse chemical shift in-phase (b) and out-of-phase (c) MR images show no signal intensity change in the nodule (arrow) between phases, a finding that indicates a high probability of metastasis. (d) Integrated PET-CT scan shows little FDG uptake (maximum SUV, 1.7) in the nodule (arrow), a finding that suggests a benign lesion. (e) Photograph of the right adrenalectomy specimen shows a solid, whitish, ovoid adrenal lesion (arrow). (f) Photomicrograph (original magnification, x100; H-E stain) of the specimen shows a metastatic lesion from lung adenocarcinoma with a predominantly bronchioloalveolar carcinoma component.
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Figure 8a. False-negative metastatic adrenal nodule at integrated PET-CT performed in a 55-year-old man with hepatocellular carcinoma. (a) Transverse unenhanced CT scan shows a 7-mm round nodule (arrow) in the left adrenal gland. (b) Integrated PET-CT scan shows lower FDG uptake (maximum SUV, 2.1) in the left adrenal gland (arrow) than in the liver, a finding that suggests a benign lesion. (c) Photomicrograph (original magnification, x100; H-E stain) of the left adrenalectomy specimen shows a metastatic lesion from hepatocellular carcinoma.
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Figure 8b. False-negative metastatic adrenal nodule at integrated PET-CT performed in a 55-year-old man with hepatocellular carcinoma. (a) Transverse unenhanced CT scan shows a 7-mm round nodule (arrow) in the left adrenal gland. (b) Integrated PET-CT scan shows lower FDG uptake (maximum SUV, 2.1) in the left adrenal gland (arrow) than in the liver, a finding that suggests a benign lesion. (c) Photomicrograph (original magnification, x100; H-E stain) of the left adrenalectomy specimen shows a metastatic lesion from hepatocellular carcinoma.
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Figure 8c. False-negative metastatic adrenal nodule at integrated PET-CT performed in a 55-year-old man with hepatocellular carcinoma. (a) Transverse unenhanced CT scan shows a 7-mm round nodule (arrow) in the left adrenal gland. (b) Integrated PET-CT scan shows lower FDG uptake (maximum SUV, 2.1) in the left adrenal gland (arrow) than in the liver, a finding that suggests a benign lesion. (c) Photomicrograph (original magnification, x100; H-E stain) of the left adrenalectomy specimen shows a metastatic lesion from hepatocellular carcinoma.
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Figure 9a. False-negative metastatic adrenal nodule at integrated PET-CT performed in a 58-year-old man with lung carcinoma. (a) Initial transverse contrast-enhanced CT scan shows a 6-mm ovoid nodule (arrow) in the left adrenal gland. (b) Integrated PET-CT scan shows lower FDG uptake (maximum SUV, 2.8) in the left adrenal gland (arrow) than in the liver, a finding that suggests a benign lesion. (c) On a follow-up CT scan obtained 15 months after a, the nodule (arrow) is 17 mm in diameter, a finding that strongly suggests a metastatic nodule.
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Figure 9b. False-negative metastatic adrenal nodule at integrated PET-CT performed in a 58-year-old man with lung carcinoma. (a) Initial transverse contrast-enhanced CT scan shows a 6-mm ovoid nodule (arrow) in the left adrenal gland. (b) Integrated PET-CT scan shows lower FDG uptake (maximum SUV, 2.8) in the left adrenal gland (arrow) than in the liver, a finding that suggests a benign lesion. (c) On a follow-up CT scan obtained 15 months after a, the nodule (arrow) is 17 mm in diameter, a finding that strongly suggests a metastatic nodule.
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Figure 9c. False-negative metastatic adrenal nodule at integrated PET-CT performed in a 58-year-old man with lung carcinoma. (a) Initial transverse contrast-enhanced CT scan shows a 6-mm ovoid nodule (arrow) in the left adrenal gland. (b) Integrated PET-CT scan shows lower FDG uptake (maximum SUV, 2.8) in the left adrenal gland (arrow) than in the liver, a finding that suggests a benign lesion. (c) On a follow-up CT scan obtained 15 months after a, the nodule (arrow) is 17 mm in diameter, a finding that strongly suggests a metastatic nodule.
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Figure 10a. False-positive adrenal adenoma at integrated PET-CT performed in a 63-year-old woman with lung adenocarcinoma. (a) Transverse contrast-enhanced CT scan shows a 21-mm heterogeneous nodule (arrow) in the left adrenal gland. (b) CT, FDG PET, and integrated PET-CT scans show increased FDG uptake (maximum SUV, 7.5) in the left adrenal gland (arrows). The adrenalectomy specimen showed adrenal adenoma.
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Figure 10b. False-positive adrenal adenoma at integrated PET-CT performed in a 63-year-old woman with lung adenocarcinoma. (a) Transverse contrast-enhanced CT scan shows a 21-mm heterogeneous nodule (arrow) in the left adrenal gland. (b) CT, FDG PET, and integrated PET-CT scans show increased FDG uptake (maximum SUV, 7.5) in the left adrenal gland (arrows). The adrenalectomy specimen showed adrenal adenoma.
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Figure 11a. Adrenal pheochromocytoma with increased FDG uptake at integrated PET-CT performed in a 33-year-old woman with multiple endocrine neoplasia type IIA. (a) Transverse contrast-enhanced CT scan shows a 4.5-cm mass (arrows) in the left adrenal gland. (b) CT, FDG PET, and integrated PET-CT scans show increased FDG uptake (maximum SUV, 5.6) in the left adrenal gland (arrows). The adrenalectomy specimen showed pheochromocytoma.
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Figure 11b. Adrenal pheochromocytoma with increased FDG uptake at integrated PET-CT performed in a 33-year-old woman with multiple endocrine neoplasia type IIA. (a) Transverse contrast-enhanced CT scan shows a 4.5-cm mass (arrows) in the left adrenal gland. (b) CT, FDG PET, and integrated PET-CT scans show increased FDG uptake (maximum SUV, 5.6) in the left adrenal gland (arrows). The adrenalectomy specimen showed pheochromocytoma.
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Figure 12a. False-positive adrenal cortical hyperplasia at integrated PET-CT performed in a 70-year-old man with squamous cell lung carcinoma. (a, b) Dynamic contrast-enhanced early-phase (a) and delayed-phase (b) adrenal CT scans show a 25-mm, ovoid nodular lesion (arrow) in the left adrenal gland. The calculated absolute percentage washout was 75%, a finding that suggested adrenal adenoma. (c) Coronal integrated PET-CT scan shows increased FDG uptake (maximum SUV, 4.6) in the nodule (arrow), a finding that suggests that the nodule is malignant. (d) Photomicrograph (original magnification, x100; H-E stain) of the left adrenalectomy specimen shows cortical hyperplasia with no evidence of malignant cellular infiltration.
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Figure 12b. False-positive adrenal cortical hyperplasia at integrated PET-CT performed in a 70-year-old man with squamous cell lung carcinoma. (a, b) Dynamic contrast-enhanced early-phase (a) and delayed-phase (b) adrenal CT scans show a 25-mm, ovoid nodular lesion (arrow) in the left adrenal gland. The calculated absolute percentage washout was 75%, a finding that suggested adrenal adenoma. (c) Coronal integrated PET-CT scan shows increased FDG uptake (maximum SUV, 4.6) in the nodule (arrow), a finding that suggests that the nodule is malignant. (d) Photomicrograph (original magnification, x100; H-E stain) of the left adrenalectomy specimen shows cortical hyperplasia with no evidence of malignant cellular infiltration.
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Figure 12c. False-positive adrenal cortical hyperplasia at integrated PET-CT performed in a 70-year-old man with squamous cell lung carcinoma. (a, b) Dynamic contrast-enhanced early-phase (a) and delayed-phase (b) adrenal CT scans show a 25-mm, ovoid nodular lesion (arrow) in the left adrenal gland. The calculated absolute percentage washout was 75%, a finding that suggested adrenal adenoma. (c) Coronal integrated PET-CT scan shows increased FDG uptake (maximum SUV, 4.6) in the nodule (arrow), a finding that suggests that the nodule is malignant. (d) Photomicrograph (original magnification, x100; H-E stain) of the left adrenalectomy specimen shows cortical hyperplasia with no evidence of malignant cellular infiltration.
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Figure 12d. False-positive adrenal cortical hyperplasia at integrated PET-CT performed in a 70-year-old man with squamous cell lung carcinoma. (a, b) Dynamic contrast-enhanced early-phase (a) and delayed-phase (b) adrenal CT scans show a 25-mm, ovoid nodular lesion (arrow) in the left adrenal gland. The calculated absolute percentage washout was 75%, a finding that suggested adrenal adenoma. (c) Coronal integrated PET-CT scan shows increased FDG uptake (maximum SUV, 4.6) in the nodule (arrow), a finding that suggests that the nodule is malignant. (d) Photomicrograph (original magnification, x100; H-E stain) of the left adrenalectomy specimen shows cortical hyperplasia with no evidence of malignant cellular infiltration.
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Figure 13a. False-positive adrenal endothelial cyst with hemorrhage at integrated PET-CT performed in a 55-year-old man with squamous cell lung carcinoma. (a) Transverse contrast-enhanced CT scan shows a 7-mm enhancing nodule (arrow) in the left adrenal gland. (b, c) Coronal FDG PET (b) and integrated PET-CT (c) scans show increased FDG uptake in a lung mass (maximum SUV, 33.5) (arrowhead) and the left adrenal gland nodule (maximum SUV, 4.3) (arrow), findings that suggest that the nodule is malignant. The patient underwent left lower lobectomy and left adrenalectomy. At histopathologic examination, the adrenal lesion proved to be an endothelial cyst with hemorrhage.
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Figure 13b. False-positive adrenal endothelial cyst with hemorrhage at integrated PET-CT performed in a 55-year-old man with squamous cell lung carcinoma. (a) Transverse contrast-enhanced CT scan shows a 7-mm enhancing nodule (arrow) in the left adrenal gland. (b, c) Coronal FDG PET (b) and integrated PET-CT (c) scans show increased FDG uptake in a lung mass (maximum SUV, 33.5) (arrowhead) and the left adrenal gland nodule (maximum SUV, 4.3) (arrow), findings that suggest that the nodule is malignant. The patient underwent left lower lobectomy and left adrenalectomy. At histopathologic examination, the adrenal lesion proved to be an endothelial cyst with hemorrhage.
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Figure 13c. False-positive adrenal endothelial cyst with hemorrhage at integrated PET-CT performed in a 55-year-old man with squamous cell lung carcinoma. (a) Transverse contrast-enhanced CT scan shows a 7-mm enhancing nodule (arrow) in the left adrenal gland. (b, c) Coronal FDG PET (b) and integrated PET-CT (c) scans show increased FDG uptake in a lung mass (maximum SUV, 33.5) (arrowhead) and the left adrenal gland nodule (maximum SUV, 4.3) (arrow), findings that suggest that the nodule is malignant. The patient underwent left lower lobectomy and left adrenalectomy. At histopathologic examination, the adrenal lesion proved to be an endothelial cyst with hemorrhage.
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Copyright © 2006 by the Radiological Society of North America.
