Paladino Nunzia Cinzia, Guérin Carole, Lowery Aoïfe, Attard Andrea, Essamet Wassim, Slotema Eveline, Morange Isabelle, Castinetti Frédéric, Brue Thierry, Loundou Anderson, Taïeb David, Sebag Frédéric
Department of General Endocrine and Metabolic Surgery, Conception University Hospital, Aix-Marseille University, 147, Boulevard Baille, 13005, Marseille, France.
Department of General Endocrine and Metabolic Surgery, Conception University Hospital, Aix-Marseille University, 147, Boulevard Baille, 13005, Marseille, France.
Surg Oncol. 2018 Jun;27(2):231-235. doi: 10.1016/j.suronc.2018.04.003. Epub 2018 Apr 23.
adrenal tumor-to-liver uptake value (Tmx:Lmx) on F-FDG PET/CT is an accurate and reproducible PET parameter in the distinction between benign and malignant adrenal masses. The potential impact of steroid hormone secretion on F-FDG uptake is still debatable. The aim of this study was to evaluate this relationship.
2010-2015: 73 patients who underwent adrenalectomy for adrenocortical tumors [49 secreting/(SA) and 24 non-secreting/(NSA)] were retrospectively included in the study. Fourteen were malignant. All patients underwent hormonal evaluation, functional and anatomical imaging, Weiss scoring and Ki 67 evaluation.
malignant tumors exhibit higher SUVmax than benign tumors (median 7.75 vs 3.06 respectively, p < 0.001) and Tmx:Lmx was 2.7 vs 1.17 for benign tumors, p < 0.001. Tmx:Lmx was positively correlated to Weiss score (p < 0.001). No significant difference was observed for Tmx:Lmx between SA and NSA overall (p = 0.851), regardless of the subgroup of tumors analyzed. Tmx:Lmx was not correlated to tumor size (p < 0.508) or 24 h free urinary cortisol level (p < 0.522).
no correlation was observed between Tmx:Lmx and hormonal status, however the correlation between ratio, malignancy and Weiss score confirm the utility of F-FDG PET/CT for the differentiation of benign from malignant adrenal lesions, irrespective of the hormone secretory status of the tumor. F-FDG PET/CT is a useful biomarker in the diagnosis of adrenal tumors, regardless of the secretion status.
F-FDG PET/CT上的肾上腺肿瘤与肝脏摄取比值（Tmx:Lmx）是鉴别肾上腺肿块良恶性的一个准确且可重复的PET参数。类固醇激素分泌对F-FDG摄取的潜在影响仍存在争议。本研究的目的是评估这种关系。
回顾性纳入2010年至2015年期间因肾上腺皮质肿瘤接受肾上腺切除术的73例患者[49例有激素分泌（SA）和24例无激素分泌（NSA）]。其中14例为恶性肿瘤。所有患者均接受了激素评估、功能和解剖成像、Weiss评分及Ki 67评估。
恶性肿瘤的SUVmax高于良性肿瘤（中位数分别为7.75和3.06，p<0.001），良性肿瘤的Tmx:Lmx为2.7，恶性肿瘤为1.17，p<0.001。Tmx:Lmx与Weiss评分呈正相关（p<0.001）。总体上，SA组和NSA组之间的Tmx:Lmx无显著差异（p=0.851），无论分析的肿瘤亚组如何。Tmx:Lmx与肿瘤大小（p<0.508）或24小时尿游离皮质醇水平（p<0.522）均无相关性。
未观察到Tmx:Lmx与激素状态之间的相关性，然而，该比值、恶性程度和Weiss评分之间的相关性证实了F-FDG PET/CT在鉴别肾上腺良性与恶性病变方面的实用性，无论肿瘤的激素分泌状态如何。F-FDG PET/CT是肾上腺肿瘤诊断中的一个有用生物标志物，与分泌状态无关。
