PD1-10 ROLE OF POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY (PET/CT) IN THE EVALUATION OF THE METASTATIC ADRENAL MASSES

Abstract

You have accessJournal of UrologyAdrenal1 Apr 2014PD1-10 ROLE OF POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY (PET/CT) IN THE EVALUATION OF THE METASTATIC ADRENAL MASSES Onur KAYGISIZ, Gokhun Ozmerdiven, Yakup Kordan, Burhan Coskun, Hakan Vuruskan, and Ismet Yavascaoglu Onur KAYGISIZOnur KAYGISIZ More articles by this author , Gokhun OzmerdivenGokhun Ozmerdiven More articles by this author , Yakup KordanYakup Kordan More articles by this author , Burhan CoskunBurhan Coskun More articles by this author , Hakan VuruskanHakan Vuruskan More articles by this author , and Ismet YavascaogluIsmet Yavascaoglu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.129AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To investigate the role of PET/CT imaging in the diagnosis of the patients with suspected non small cell lung cancer (NSCLC) metastases in the adrenal gland. METHODS Forty-one patients with suspected metastases Laparoscopic Adrenalectomy was performed in our clinic between March 2004 and July 2013. Fourteen patients without PET imaging were excluded from the study. The primary tumors in 22 were NSCLC. The parameters of the patients and peak standardized uptake values (SUVmax) were compared between the groups with benign and malignant pathologies. RESULTS Metastases were found in 17 adrenal masses (74%). Sex of the patient, sub-type of the lung cancer and the size of the adrenal mass were ineffective for the prediction of the metastasis (table). Together with this, the SUVmax value was found as significantly higher in the metastatic group (table). If the threshold value of SUV max for metastatic were taken as 3, sensitivity would be 100% and specificity would be 50%; whereas if the same value were taken as 4 or 5, sensitivity would be 88.2% and 76.5, respectively, and specificity would be 82.4% and 100%, respectively. CT or MRI were ineffective in determining the metastases (p=0,179). Specificity was 83.3%, while sensitivity was only 60%. However, in case we accepted the presence of suspicious metastasis based on CT or MRI as the criterion in the group we took the SUV max threshold value as 4, one patient more would be diagnosed to increase sensitivity to 94.11% and to decrease specificity to 66%. Likewise, taking the threshold SUV max value as 5 would allow diagnosing of 2 more patients and diagnosis of only 1 patient would be missed increasing sensitivity to 94.1% and lowering specificity to 83.3%. CONCLUSIONS In our series, PET/CT appears as an effective imaging modality to determine the adrenal metastases in patients with NSCLC as the primary disease. Follow-up may be considered in the first place for patients with SUV max values smaller than 3. SUVmax threshold value 5 sensitivity can be increased by combining with CT or MRI. Table. Comparison of the patients with primary NSCLC tumors in groups with and without metastasis Benign Grup 1 (n=6) Metastasis (Grup 2) (n=17) P Age (year)a 64,3±7,4 56,2± 7,8 0,047 SUVmaxa 2,8± 1,3 9,3±4,9 <0,001 Adrenal mass diameter (mm)a 26,0± 9,5 29± 15,5 0,617 Gender male 4 16 (80%) 0,155 female 2 1 (33,3%) Lung cancer subtypes Squamoz 3 7 (70%) 0,708 Adenocancer 3 10 (76,9%) CT/MRI benign 5 6 0,149 metastasis 1 9 SUV maxb ≤3 3 0 (0%) 0,011 > 3 3 17 (85%) SUV maxb ≤4 5 2 (28,6%) 0,003 > 4 1 15(93,8%) SUV maxb ≤5 6 3 (33,3%) 0,001 >5 0 14 (100%) SUVmax/ MRI-CT ≤5, benign 5 1 (16,7%) 0,001 > 5, metastasis 1 16 (94,1%) © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e13-e14 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Onur KAYGISIZ More articles by this author Gokhun Ozmerdiven More articles by this author Yakup Kordan More articles by this author Burhan Coskun More articles by this author Hakan Vuruskan More articles by this author Ismet Yavascaoglu More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...