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Congress: ECR25
Poster Number: C-21429
Type: Poster: EPOS Radiologist (educational)
Authorblock: S. Tzamouri, S. Georgiadi, C. Koukoula, M. Tzanela, D. A. Vassiliadi, G. Kyriakopoulos, E. Lazaridou, S. Kapiris, D. N. Exarhos; Athens/GR
Disclosures:
Stavroula Tzamouri: Nothing to disclose
Sofia Georgiadi: Nothing to disclose
Chrysoula Koukoula: Nothing to disclose
Marinella Tzanela: Nothing to disclose
Dimitra A Vassiliadi: Nothing to disclose
Georgios Kyriakopoulos: Nothing to disclose
Eleni Lazaridou: Nothing to disclose
Stylianos Kapiris: Nothing to disclose
Demetrios N. Exarhos: Nothing to disclose
Keywords: Abdomen, Management, Oncology, CT, MR, PET, Comparative studies, Diagnostic procedure, Endocrine disorders, Neoplasia, Tissue characterisation
Learning objectives -Highlight key imaging characteristics of indeterminate adrenal lesions across a range of adrenal pathologies.-Identify specific imaging features as diagnostic keys of differentiation between benign and malignant entities.-Improve the clinical decision process in daily routine.
Read more Background The incidental detection of adrenal lesions has become increasingly common due to the widespread use of cross-sectional abdominal imaging modalities.Indeterminate Adrenal LesionsIndeterminate adrenal lesions refer to adrenal masses that do not exhibit clear imaging features allowing for definitive classification as benign or malignant. These lesions often lack the homogeneous, lipid-rich appearance (<10 HU on Non-Contrast CT) typical of benign adenomas and may demonstrate intermediate attenuation, heterogeneous enhancement, atypical imaging characteristics and a size < 1 cm. They pose a diagnostic...
Read more Findings and procedure details We present a series of characteristic cases involving patients with indeterminate adrenal lesions. These cases encompass a broad spectrum of adrenal pathologies, illustrated using various imaging modalities, with final confirmation through histopathological examination.Adenomas Lipid-Rich Adenomas: Approximately 70% of adrenal adenomas contain high intracellular lipid content, resulting in low attenuation values (≤10 HU) on NNCT. They are typically homogeneous with smooth contours and do not require further evaluation. [fig 5] Lipid-Poor Adenomas: The remaining 30% of adenomas lack sufficient intracellular lipid, rendering them indistinguishable...
Read more Conclusion Indeterminate adrenal lesions are not rare. Imaging is essential in diagnosing and managing these masses. Examining characteristic imaging findings, later correlated with histopathological confirmation, goals to enhance radiologists' ability to differentiate easily between benign and malignant lesions. A multi-modality imaging approach, along with a comprehensive hormonal workup, aims to provide a more accurate and thorough diagnosis of adrenal lesions.
Read more References - Linwah Yip; Mitchell E. Tublin; John A. Falcone; Cory R. Nordman; Michael T. Stang; Jennifer B. Ogilvie; Sally E. Carty; John H. Yim. (2010). The Adrenal Mass: Correlation of Histopathology with Imaging. , 17(3), 846–852. doi:10.1245/s10434-009-0829-2 - Julie H. Song, Fakhra S. Chaudhry, and William W. Mayo-Smith The Incidental Indeterminate Adrenal Mass on CT (> 10 H) in Patients Without Cancer: Is Further Imaging Necessary? Follow-Up of 321 Consecutive Indeterminate Adrenal Masses. American Journal of RoentgenologyVolume 189, Issue 5November 2007Pages1011-1163- Anju Sahdeva...
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