Practical Approach to Adrenal Imaging

Various pathologies can affect the adrenal gland. Noninvasive cross-sectional imaging is used for evaluating adrenal masses. Accurate diagnosis of adrenal lesions is critical, especially in cancer patients; the presence of adrenal metastasis changes prognosis and treatment. Characterization of adrenal lesions predominantly relies on morphologic and physiologic features to enable correct diagnosis and management. Key diagnostic features to differentiate benign and malignant adrenal lesions include presence/absence of intracytoplasmic lipid, fat cells, hemorrhage, calcification, or necrosis and locoregional and distant disease; enhancement pattern and washout values; and lesion size and stability. This article reviews a spectrum of adrenal pathologies.