July - September 2020, Volume 16, Issue 3

Vukomanovic V, Matovic M, Djukic A, Ignjatovic V, Vuleta K, Djukic S, Vukomanovic IS

The Role of Tumor-Seeking Radiopharmaceuticals in the Diagnosis and Management of Adrenal Tumors

Acta Endo (Buc) 2020, 16 (3): 316-323
doi: 10.4183/aeb.2020.316

Context. The variety of tumor-seeking radiopharmaceuticals, which are currently in clinical use, may have a potential role as imaging agents for adrenal gland tumors, due to physiological characteristics of this organ. Objective. The purpose of this study was to evaluate the diagnostic potential of 99mTc-HYNIC-TOC, 99mTc(V)- DMSA, and 99mTc-MIBI in the assessment of adrenal tumors, by correlating with imaging findings and histopathologic results. Design. The research is designed as a crosssectional prospective study. Patients and method. The study included 50 patients with adrenal tumors (19 hormone-secreting and 31 nonfunctioning) and 23 controls without adrenal involvement. In all patients, single-photon emission computed tomography (SPECT) was performed, using qualitative and semiquantitative analysis. The tumor to nontumor tracer uptake was conducted by using a region-ofinterest technique. Adrenal to background (A/B) ratio was calculated in all cases. Results. 99mTc-HYNIC-TOC scintigraphy showed a high statistical significance between A/B ratios, while other two tracers resulted in a lower sensitivity, specificity and accuracy. Futhermore, 99mTc-HYNIC-TOC could have a high diagnostic yield to detect adrenal tumors (the receiveroperating- characteristic curve analysis, A/B ratio cut-off value of 8.40). Conclusion. A semiquantitative SPECT analysis showed that 99mTc-HYNIC-TOC is a highly sensitive tumorseeking agent for the accurate localization of adrenal tumors.

Keywords: scintigraphy, adrenal tumor, 99mTc(V)-DMSA, 99mTc-HYNIC-TOC, 99mTc-MIBI.

Correspondence: Ivana Simic Vukomanovic, MD, PhD, University of Kragujevac, Serbia, Faculty of Medical Sciences, 69 Svetozara Markovica street, 34000 Kragujevac, Serbia, E-mail: drivanasimic@gmail.com