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ACR Appropriateness Criteria® Adrenal Mass Evaluation: 2021 Update.
, Rekha N Mody1, Erick M Remer2
1Department of Radiology, Cleveland Clinic, Cleveland, Ohio.
Journal of the American College of Radiology : JACR
|November 19, 2021
Summary
Evaluating adrenal masses, especially incidentalomas, requires careful radiological and biochemical assessment. Clinical context, patient history, and symptoms guide appropriate imaging strategies for accurate diagnosis.
Area of Science:
- Endocrinology
- Radiology
- Medical Imaging
Background:
- Adrenal masses are frequently discovered incidentally during imaging for other conditions.
- While most adrenal incidentalomas are benign, thorough evaluation is crucial for diagnosis.
- Clinical presentation, including history of malignancy or hormonal symptoms, dictates diagnostic pathways.
Purpose of the Study:
- To review current imaging approaches for adrenal masses.
- To discuss various imaging modalities used in adrenal lesion evaluation.
- To provide evidence-based guidelines for appropriate adrenal mass assessment.
Main Methods:
- Review of current medical literature from peer-reviewed journals.
- Application of established methodologies like RAND/UCLA Appropriateness Method and GRADE.
- Expert opinion to supplement evidence where lacking or equivocal.
Main Results:
- Adrenal mass evaluation is highly dependent on clinical context.
- Different imaging strategies are required for incidentalomas versus masses in patients with specific histories or symptoms.
- Guidelines address the appropriateness of imaging and treatment for various clinical scenarios.
Conclusions:
- Appropriate evaluation of adrenal masses necessitates a tailored approach based on clinical circumstances.
- Radiological and biochemical assessments are vital for diagnosing adrenal incidentalomas.
- Evidence-based guidelines, informed by literature and expert consensus, aid in decision-making for adrenal mass management.
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