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Imaging incidental adrenal lesions.

Anju Sahdev1,2

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Incidental adrenal masses are common, with most being benign. This review details imaging for characterizing these masses and managing indeterminate lesions through multidisciplinary teams and advanced imaging.

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Area of Science:

  • Radiology
  • Endocrinology
  • Oncology

Background:

  • Incidental adrenal masses are frequently discovered during imaging for other conditions.
  • Most adrenal masses are benign, commonly adenomas or myelolipomas.
  • Characterizing these lesions is crucial for appropriate patient management.

Purpose of the Study:

  • To review imaging features of benign and malignant adrenal masses.
  • To propose an imaging pathway for indeterminate adrenal masses.
  • To emphasize the role of multidisciplinary teams in managing complex cases.

Main Methods:

  • Review of cross-sectional imaging (CT and MRI) features.
  • Discussion of advanced imaging techniques: scintigraphy, PET-CT, biopsy.
  • Integration of biochemical and hormonal evaluations.

Main Results:

  • CT and MRI can characterize over 80% of adrenal masses.
  • Indeterminate lesions require further investigation due to shared benign/malignant features.
  • Multidisciplinary team (MDT) approach is vital for indeterminate lesions.

Conclusions:

  • Accurate characterization of adrenal masses relies on imaging features and clinical context.
  • A structured imaging pathway aids in managing indeterminate adrenal masses.
  • Collaboration and advanced diagnostics are key for optimal outcomes.