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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 11/2014

01-11-2014 | Original Article

Impact of 18F-FDG PET/CT on the management of adrenocortical carcinoma: analysis of 106 patients

Authors: Satoshi Takeuchi, Aparna Balachandran, Mouhammed Amir Habra, Alexandria T. Phan, Roland L. Bassett Jr., Homer A. Macapinlac, Hubert H. Chuang

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 11/2014

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Abstract

Purpose

Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Limited data are available about on value of 18F-FDG PET/CT in ACC. We evaluated the impact of PET/CT on the management of ACC.

Methods

We performed a retrospective review in patients with ACC who had undergone PET/CT. The impact of PET/CT on the management plan was evaluated by comparing the findings on PET/CT to the findings on contrast-enhanced CT. The sensitivity, specificity, and accuracy of each form of imaging were calculated. The correlations between PET/CT parameters, including maximum standardized uptake value (SUVmax), total lesion glycolysis, and decline in SUVmax after chemotherapy, and clinical outcome were evaluated.

Results

Included in the analysis were 106 patients with 180 PET/CT scans. Of the 106 patients, 7 underwent PET/CT only for initial staging, 84 underwent PET/CT only for restaging, and 15 underwent PET/CT for both initial staging and restaging. PET/CT changed the management plan in 1 of 22 patients (5 %) at initial staging and 9 of 99 patients (9 %) at restaging. In 5 of the patients in whom PET/CT changed the management plan, PET/CT showed response to chemotherapy but contrast-enhanced CT showed stable disease. Sensitivity, specificity, and accuracy were 100 %, 100 %, and 100 % for PET/CT at initial staging; 92.6 %, 100 %, and 96.4 % for CT at initial staging; 98.4 %, 100 %, and 99.5 % for PET/CT at restaging; and 96.8 %, 98.6 %, and 98.0 % for CT at restaging, respectively. No PET/CT parameters were associated with survival at either initial diagnosis or recurrence.

Conclusion

PET/CT findings could substantially change the management plan in a small proportion of patients with ACC. Although lesion detection was similar between PET/CT and CT, PET/CT may be preferred for chemotherapeutic response assessment because it may predict response before anatomic changes are detected on CT.
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Metadata
Title
Impact of 18F-FDG PET/CT on the management of adrenocortical carcinoma: analysis of 106 patients
Authors
Satoshi Takeuchi
Aparna Balachandran
Mouhammed Amir Habra
Alexandria T. Phan
Roland L. Bassett Jr.
Homer A. Macapinlac
Hubert H. Chuang
Publication date
01-11-2014
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 11/2014
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-014-2834-3

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