- “ The prevalence of incidental adrenal masses in abdominal CT is approximately 4%, ranging from 0.2% in patients 20-29 years old to 7% in patients over 70 years old.”
Prevalence of adrenal incidentaloma in a contemporary computerized tomography series.”
J Endocrinol Invest
2006; 29:298-302
- Adrenal Pseudocyst
-Sequela of previous hemorrhage
-Unilocular or multilocular
-Calcification in 43%
-Pseudocyst can be present with an adrenal tumor "The goal of imaging when an incidental adrenal mass is discovered is to differentiate a benign "leave alone" mass (eg.nonhyperfunctioning tumor,myelolipoma,hemorrhage,cyst) from a mass that warrants treatment (eg, metastases, pheochromocytoma,adrenal cortical carcinoma)." Managing Incidental Findings on Abdominal CT: White Paper of the ACR Incidental Findings Committee
Berland LL et al.
J Am Coll Radiol 2010;7;754-773 "This white paper which represents the collective experience of the Incidental Findings Committee, using a less formal process of repeated reviews and revisions of the draft document, does not represent official ACR policy. For these reasons, this white paper should not be used to establish the legal standard of care in any particular situation." Managing Incidental Findings on Abdominal CT: White Paper of the ACR Incidental Findings Committee
Berland LL et al.
J Am Coll Radiol 2010;7;754-773 "The committee has used a consensus method based on repeated reviews and revisions of this document and a collective review and interpretation of relevant literature. This white paper provides guidance devloped by this committee for addressing incidental findings in the kidneys, liver , adrenal gland and pancreas." Managing Incidental Findings on Abdominal CT: White Paper of the ACR Incidental Findings Committee
Berland LL et al.
J Am Coll Radiol 2010;7;754-773 - "All of the incidentally detected adrenal masses with a CT attenuation of >10 HU were benign in patients with no known malignancy. Follow-up imaging to characterize an incidental mass appears to have a limited role in this patient cohort."
The Incidental Indeterminate Adrenal Mass on CT (>10H) in Patients Without Cancer: Is Further Imaging Necessary? Follow-Up of 321 Consecutive Indeterminate Adrenal Masses Song JH et al. AJR 2007; 189:1119-1123 - "In conclusion, the results of our study show that none of the incidentally detected adrenal masses was malignant in patients with no known cancer. If an incidental adrenal mass appears benign on imaging and the patient has no known malignancy, follow-up imaging appears to have a limited role."
The Incidental Indeterminate Adrenal Mass on CT (>10H) in Patients Without Cancer: Is Further Imaging Necessary? Follow-Up of 321 Consecutive Indeterminate Adrenal Masses Song JH et al. AJR 2007; 189:1119-1123 - "All of the incidentally detected adrenal masses with a CT attenuation of >10 HU were benign in patients with no known malignancy. Follow-up imaging to characterize an incidental mass appears to have a limited role in this patient cohort."
The Incidental Indeterminate Adrenal Mass on CT (>10H) in Patients Without Cancer: Is Further Imaging Necessary? Follow-Up of 321 Consecutive Indeterminate Adrenal Masses Song JH et al. AJR 2007; 189:1119-1123 - "In conclusion, the results of our study show that none of the incidentally detected adrenal masses was malignant in patients with no known cancer. If an incidental adrenal mass appears benign on imaging and the patient has no known malignancy, follow-up imaging appears to have a limited role."
The Incidental Indeterminate Adrenal Mass on CT (>10H) in Patients Without Cancer: Is Further Imaging Necessary? Follow-Up of 321 Consecutive Indeterminate Adrenal Masses Song JH et al. AJR 2007; 189:1119-1123 - "All of the incidentally detected adrenal masses with a CT attenuation of >10HU were benign in patients with no known malignancy. Follow-up imaging to characterize an incidental adrenal mass appears to have a limited role in this patient cohort." The Incidental Indeterminate Adrenal Mass on CT (> 10HU) in Patients Without Cancer: Is Further Imaging Necessary? Follow-Up of 321 Consecutive Indeterminate Adrenal Masses Song JH et al. AJR 2007; 189:1119-1123
- Objective: The objective of our study was to determine whether follow-up imaging evaluation is necessary for incidentally discovered indeterminate adrenal lesions (>10HU) on CT in patients with no known malignancy. Conclusion:All of the incidentally detected adrenal masses with a CT attenuation of >10HU were benign in patients with no known malignancy. Follow-up imaging to characterize an incidental adrenal mass appears to have a limited role in this patient cohort.
- "There are only slight differences in attenuation of adrenal nodules measured on scans obtained with different scanners." Adrenal Lesions: Attenuation measurement Differences between CT Scanners Hahn PF et al. Radiology 2006; 240:458-463.
- Absolute Contrast Enhancement Washout
-[(E-D/E-U)] x 100
- Where E is the enhanced attenuation value, D is the delayed enhancement value, and U is the unenhanced value
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