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Adrenal functional imaging.

Rudolf A Werner1, Andreas Schirbel1, Andreas K Buck1

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This summary is machine-generated.

Molecular imaging offers advanced techniques to differentiate benign from malignant adrenal masses, which are often incidentally discovered. These methods are evolving towards targeted therapies for adrenal cancers.

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Area of Science:

  • Nuclear Medicine
  • Radiology
  • Oncology

Background:

  • Incidental adrenal masses are increasingly found due to widespread conventional imaging (MRI, CT).
  • Morphological imaging alone often fails to reliably distinguish benign from malignant adrenal lesions.
  • Molecular functional imaging provides non-invasive, sub-cellular insights for better characterization.

Purpose of the Study:

  • To review established and novel molecular imaging biomarkers for adrenal masses.
  • To highlight the transition of molecular imaging from diagnostic to therapeutic applications.
  • To focus on image-guided therapeutic approaches for adrenocortical carcinoma.

Main Methods:

  • Review of current literature on molecular imaging tracers for adrenal masses.
  • Discussion of positron emission tomography (PET) and single photon emission computed tomography (SPECT) tracers.
  • Exploration of tracers targeting glucose metabolism ([18F]FDG), adrenal cortex (CYP11B, CXCR4), and adrenal medulla (MIBG, DOPA, DOTATOC/-TATE).

Main Results:

  • [18F]FDG-PET is used to distinguish malignant from benign adrenal lesions based on glucose consumption.
  • Adrenal cortex-specific tracers (Iodometomidate, IMAZA, Pentixafor) aid in diagnosing cortical tumors.
  • Medulla-targeting tracers (MIBG, DOPA, DOTATOC/-TATE) are effective for pheochromocytoma detection.

Conclusions:

  • Molecular imaging biomarkers are crucial for characterizing adrenal masses.
  • Radiotracers show potential for theranostic applications, combining diagnosis and therapy.
  • The field is advancing towards image-guided therapeutic strategies, particularly for adrenocortical carcinoma.