Adrenal tumour imaging: clinical, molecular, and radiomics perspectives.
Authors
Affiliations (12)
Affiliations (12)
- Center for Adrenal Endocrine Tumours, AKESO, Prague, Czech Republic; Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
- Division of Endocrinology, Department of Medicine, Boston Medical Center, Brighton, MA, USA.
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
- Nuclear Medicine, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France; Nuclear Medicine and Molecular Imaging, ICANS, Strasbourg, France; IPHC, CNRS/Unistra, Strasbourg, France.
- Diagnostic Department, Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, University of Geneva, Geneva, Switzerland; Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell'Obesità (CREO), Università Cattolica del Sacro Cuore, Rome, Italy.
- Department of Radiology, University Hospital Olomouc, Olomouc, Czech Republic; Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic.
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands.
- Green Templeton College, University of Oxford, Oxford, UK; Centre for Endocrinology Barts, London School of Medicine and Dentistry, Queen Mary University of London, London, UK; NET Unit, ENETS Centre of Excellence, Royal Free Hospital, London, UK.
- Department of Internal Medicine IV, LMU University Hospital, Munich, Germany; Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland.
- Department of Nuclear Medicine, La Timone University Hospital, ERL INSERM U 1326, Aix-Marseille University, Marseille, France.
Abstract
Adrenal tumours have become a common incidental finding in the radiological evaluation of patients. Estimates suggest that 1-10% of the general population currently harbours an adrenal tumour, peaking in prevalence in the seventh and eighth decades of life. Advances in CT and MR have contributed to improved characterisation of adrenal masses, and novel radiopharmaceuticals are being developed for molecular characterisation and disease subtyping. As a result, the imaging and management of adrenal tumours have been important subjects of many guidelines and consensus statements. New radiomics approaches, together with machine learning, are now being introduced and are quickly shaping the way that imaging data are analysed and interpreted. Furthermore, the development of theranostics links the molecular biology of functioning tumours to targeted treatment options. In this Review, we summarise up-to-date imaging and follow-up approaches for adrenal tumours to provide patients with the most accurate diagnosis, thereby avoiding unnecessary additional tests or surgery.