Role of 18F-fluorodeoxyglucose positron-emission tomography/computed tomography in restaging of adrenocortical carcinoma

Background: The objective was to retrospectively evaluate the contribution of fluorodeoxyglucose [F-18] positron emission tomography/computed tomography ((18)FDG-PET/CT) to the re-staging of adrenocortical carcinoma (ACC). Materials and methods: A total of 16 patients (10 males and 6 females), who underwent adrenalectomy due to adrenocortical carcinoma and (18)FDG-PET/CT scan to re-stage the tumor between July 2007 and April 2013, were included in the present study. The mean age was 53.37 +/- 13.91 years (min: 30, max: 74) The patients were required to fast for six hours prior to scanning, and whole-body PET scanning from the skull base to the upper thighs was performed approximately 1 h after the intravenous injection of 555 MBq of F-18 FDG. Whole body CT scanning was performed in the cranio-caudal direction. FDG-PET images were reconstructed using CT data for attenuation correction. Suspicious recurrent or metastatic lesions were confirmed by histopathology or clinical follow-up. Results: Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of (18)FDG-PET/CT were 100%, 83.3%, 90.9%, 83.3%, and 93.7%, respectively. Conclusion: 18FDG-PET/CT detects local recurrence and/or distant metastases with high accuracy in the re-staging of operated adrenocortical carcinoma. It is considered that the procedure could play an important role in treatment decision after the operation and post- operative follow-up and could influence the entire decision-making process.