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Adrenal Metastasis: Diagnostic Strategies and Key Considerations
Robert D Petrocelli1, Jesi Kim2, Khaled M Elsayes3
1Department of Radiology, Abdominal Imaging Section, New York University Grossman School of Medicine, 660 1st Avenue, 3rd Floor, New York, NY 10016, USA.
Magnetic Resonance Imaging Clinics of North America
|August 11, 2026
Summary
Distinguishing adrenal lesions is crucial, even in cancer patients, as most are benign. This review details imaging techniques like CT, MR, and PET/CT to assess malignancy risk and guide clinical decisions.
Area of Science:
- Radiology
- Oncology
- Endocrinology
Background:
- Adrenal lesions are frequently detected during imaging.
- Most adrenal lesions are benign, even in patients with existing cancers.
- Accurate differentiation between benign lesions and adrenal metastases is vital for patient management.
Purpose of the Study:
- To review imaging strategies for evaluating adrenal lesion malignancy risk.
- To provide a structured, risk-based approach for clinical decision-making.
- To enhance diagnostic accuracy in differentiating benign from malignant adrenal lesions.
Main Methods:
- Review of imaging modalities including computed tomography (CT), MR imaging, and FDG PET/CT.
- Integration of lesion characteristics such as size, growth rate, and fat content.
- Assessment of ancillary imaging features to stratify malignancy likelihood.
Main Results:
- Imaging strategies can effectively evaluate the risk of malignancy in adrenal lesions.
- A structured approach aids in clinical decision-making and improves diagnostic accuracy.
- Key challenges include interpreting fat-containing metastases and atypical adenomas, and understanding CT washout limitations.
Conclusions:
- Imaging plays a critical role in assessing adrenal lesions.
- A comprehensive evaluation integrating multiple imaging features optimizes diagnostic accuracy.
- Further research may address challenges in differentiating specific types of adrenal lesions.
