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DOI: 10.1148/radiol.2383042164
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Adrenal Lesions: Characterization with Fused PET/CT Image in Patients with Proved or Suspected Malignancy—Initial Experience1

Michael A. Blake, MRCPI, BSc, FRCR, FFR RCSI, James M. A. Slattery, MRCPI, FRCR, FFR RCSI, Mannudeep K. Kalra, MD, DNB, Elkan F. Halpern, PhD, Alan J. Fischman, MD, PhD, Peter R. Mueller, MD and Giles W. Boland, MD

1 From the Division of Abdominal and Interventional Radiology (M.A.B., J.M.A.S., M.K.K., P.R.M., G.W.B.) and Department of Nuclear Medicine (A.J.F.), White 270, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; and Institute for Technology Assessment, Boston, Mass (E.F.H.). Received December 21, 2004; revision requested February 22, 2005; revision received July 9; final version accepted August 2. Address correspondence to M.A.B.


Figure 1
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  		Figure 1: Box plot of SUVs for benign and malignant lesions (excluding the highest value for a malignant lesion of 26.13) demonstrates considerable difference between absolute SUV values of benign lesions and those of malignant lesions.

 

Figure 2
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  		Figure 2: Box plot of adrenal gland–liver FDG activity for benign and malignant lesions (excluding the highest value for malignant lesions of 17.08) illustrates that all benign lesions had FDG activity of less than 1.5 times that of liver, whereas all malignant lesions had FDG activity of greater than 1.5 times that of liver.

 

Figure 3
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  		Figure 3: True-positive PET/CT images. Composite transverse (top) and coronal (bottom) CT (left), fused PET/CT (center), and PET (right) images coregistered to the right adrenal gland in 63-year-old man with lymphoma demonstrate intense FDG activity. FDG activity is clearly greater than that of the liver, and this activity suggests metastatic disease.

 

Figure 4
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  		Figure 4: True-negative PET/CT images. Composite transverse (top) and coronal (bottom) CT (left), fused PET/CT (center), and PET (right) images coregistered to the left adrenal gland in 68-year-old man with left adrenal adenoma demonstrate absence of FDG activity (<10 HU at nonenhanced CT).

 

Figure 5
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  		Figure 5: False-positive PET/CT images. Composite transverse (top) and coronal (bottom) CT (left), fused PET/CT (center), and PET (right) images coregistered to the left adrenal gland in 74-year-old woman with left adrenal lesion (arrows) demonstrate mildly increased FDG activity (>10 HU at nonenhanced CT). This lesion was confirmed to be an adenoma at delayed contrast-enhanced CT and percutaneous biopsy.

 




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