Indian Journal of Nuclear Medicine

ORIGINAL ARTICLE
Year
: 2022  |  Volume : 37  |  Issue : 3  |  Page : 227--235

Fluoro-2-deoxyglucose-positron emission tomography/computed tomography in the diagnosis and management of adrenocortical carcinoma: A 10-year experience from a tertiary care institute


Venkata Subramanian Krishnaraju1, Rajender Kumar1, Karthikeyan Subramanian1, Bhagwant Rai Mittal1, Harmandeep Singh1, Debajyoti Chatterjee2, Rama Walia3 
1 Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
3 Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Dr. Bhagwant Rai Mittal
Department of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh - 160 012
India

Purpose: Adrenocortical carcinoma (ACC) is a rare primary malignancy of the adrenal gland. The present study was aimed to compare the performance of fluoro-2-deoxyglucose-positron emission tomography–computed tomography (FDG-PET-CT) compared to contrast-enhanced computed tomography (CECT) in diagnosis and management of ACC. Materials and Methods: A retrospective analysis of the PET-CT studies from January 2010 to October 2020 was performed. Patients with adrenal lesions suspicious of ACC and diagnosed cases of ACC who underwent PET-CT for staging, restaging, and surveillance were reanalyzed. The PET-CT parameters were compared with the clinical, biochemical, histopathological, and CECT parameters. Results: The study included 96 scans performed in 77 patients (36 males, aged 40.4 ± 17.9 years). Of these, 55 scans were performed to diagnose and stage suspected ACC (30 of them diagnosed as ACC), 31 for restaging, and 10 scans for surveillance of ACC. PET/CT revealed metastases from an extra-adrenal primary in 5/55 patients. FDG-PET-CT had a sensitivity and specificity of 100% and 70% to diagnose ACC. Standardized uptake value-peak more than 5.4 had a sensitivity of 90.9% and specificity of 91.7% for differentiating ACC from non-ACC lesions, while tumor-to-liver ratio peak (TLRpeak) of 3.3 was most specific. PET-CT changed the staging in 23.3% of the patients with an accuracy of 100%. PET-CT changed the management plan in 25.8% of the patients during restaging with a sensitivity and specificity of 95.6% and 100%, respectively. For surveillance, CECT was as sensitive as PET-CT; however, PET-CT was more specific (100% vs. 97.9%). Conclusion: FDG-PET-CT performs better than CECT in the diagnosis, staging, restaging, and surveillance of ACC.


How to cite this article:
Krishnaraju VS, Kumar R, Subramanian K, Mittal BR, Singh H, Chatterjee D, Walia R. Fluoro-2-deoxyglucose-positron emission tomography/computed tomography in the diagnosis and management of adrenocortical carcinoma: A 10-year experience from a tertiary care institute.Indian J Nucl Med 2022;37:227-235


How to cite this URL:
Krishnaraju VS, Kumar R, Subramanian K, Mittal BR, Singh H, Chatterjee D, Walia R. Fluoro-2-deoxyglucose-positron emission tomography/computed tomography in the diagnosis and management of adrenocortical carcinoma: A 10-year experience from a tertiary care institute. Indian J Nucl Med [serial online] 2022 [cited 2022 Nov 30 ];37:227-235
Available from: https://www.ijnm.in/article.asp?issn=0972-3919;year=2022;volume=37;issue=3;spage=227;epage=235;aulast=Krishnaraju;type=0