Scintigraphy of hyperfunctioning adrenal tissue after total adrenalectomy

Area of Science:

• Endocrinology
• Nuclear Medicine
• Surgical Oncology

Background:

• Recurrence of Cushing's syndrome can occur after total adrenalectomy due to residual hyperfunctioning adrenal tissue.
• Accurate localization of this tissue is crucial for effective management and potential re-operation.

Purpose of the Study:

• To evaluate the significance of scintigraphic examination in identifying hyperfunctioning adrenal tissue post-adrenalectomy.
• To assess the utility of 131I-19-iodocholesterol scintigraphy in patients with suspected recurrent Cushing's syndrome.

Main Methods:

• Scintigraphic examination was performed 7-8 days post-injection of 1 mCi of 131I-19-iodocholesterol.
• Utilized a Jumbo Thoshiba 202 scintillation camera and Informatek SIMIS 3 data processing system.
• Examined four patients with clinical suspicion of hyperfunctioning adrenal tissue after total adrenalectomy.

Main Results:

• 131I-19-iodocholesterol concentrated in the adrenal region in all four patients.
• Localization occurred in the right adrenal region in three cases and the left in one.
• Scintigraphy confirmed recurrent Cushing's syndrome due to residual adrenal tissue, aiding in two re-operation cases.

Conclusions:

• Adrenal scintigraphy is a valuable method for locating hyperfunctioning adrenal tissue left after total adrenalectomy.
• This imaging modality accurately identifies residual tissue, facilitating surgical re-intervention.
• Scintigraphy confirms clinical suspicion and aids in the diagnosis of recurrent Cushing's syndrome.