Imaging evaluation of the non-functioning indeterminate adrenal mass

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• Incidental adrenal masses are frequently found during abdominal imaging for symptoms or cancer staging.
• Distinguishing benign from malignant adrenal masses is a key clinical challenge.
• While some masses have clear imaging signs, lipid-poor adenomas can mimic malignant lesions.

Purpose of the Study:

• To review recent advances in imaging modalities for adrenal mass characterization.
• To discuss the utility of computed tomography, magnetic resonance imaging, and positron emission tomography in differentiating benign and malignant adrenal lesions.
• To highlight imaging features that aid in distinguishing adrenal adenomas from carcinomas and metastases.

Main Methods:

• Review of recent literature on advanced imaging techniques for adrenal masses.
• Analysis of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) findings.
• Comparison of imaging appearances of benign adrenal lesions (e.g., myelolipomas, cysts) and malignant ones (e.g., metastases, carcinomas).

Main Results:

• Pathognomonic imaging findings exist for many benign adrenal masses.
• Significant overlap in imaging appearance between lipid-poor adenomas and malignant lesions necessitates advanced diagnostic approaches.
• Recent advancements in CT, MRI, and PET offer improved capabilities for distinguishing these lesions.

Conclusions:

• Advanced imaging plays a crucial role in the workup of incidental adrenal masses.
• Computed tomography, magnetic resonance imaging, and positron emission tomography provide valuable tools to differentiate benign adenomas from malignant adrenal lesions.
• Continued research into novel imaging techniques is essential for accurate adrenal mass characterization.