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Adrenal Mass Biopsy in Patients Without Extraadrenal Primary Malignancy: A Multicenter Study
Satheesh Krishna1,2, Brian M Moloney1,2, Bo Bao3
1Department of Medical Imaging, University of Toronto, 200 Elizabeth St, Toronto, ON M5G 2C4, Canada.
AJR. American Journal of Roentgenology
|October 25, 2023
Summary
Adrenal mass biopsy has limited utility for evaluating incidental adrenal masses in patients without known extraadrenal malignancy, showing low diagnostic yield, sensitivity, and specificity for malignancy.
Area of Science:
- Endocrinology
- Radiology
- Oncology
Background:
- Incidental adrenal masses are common findings.
- Adrenal washout CT is not useful for evaluating these masses.
- No clear diagnostic pathway exists for incidental adrenal masses in patients without known extraadrenal malignancy.
Purpose of the Study:
- To evaluate the diagnostic utility of adrenal mass biopsy.
- To assess the accuracy of adrenal mass biopsy in patients without known or suspected extraadrenal primary malignancy.
Main Methods:
- Retrospective six-center study of 69 patients undergoing image-guided core needle biopsy for adrenal masses.
- Biopsy results classified as diagnostic or nondiagnostic.
- Histopathologic concordance assessed for resected masses; masses classified by resection or imaging follow-up.
Main Results:
- Adrenal mass biopsy had a diagnostic yield of 64%.
- Diagnostic biopsies showed 96% sensitivity and 100% specificity for malignancy.
- Overall biopsy sensitivity was 73% and specificity was 54% for malignancy.
Conclusions:
- Adrenal mass biopsy has low diagnostic yield, sensitivity, and specificity for malignancy.
- Biopsy results of adrenocortical neoplasm did not reliably differentiate benign from malignant masses.
- Biopsy has limited utility for evaluating incidental adrenal masses in this patient population.
