ECE2015 Eposter Presentations Adrenal cortex (94 abstracts)
Role for 131I-6β-iodomethyl-norcholesterol scintigraphy in subclinical Cushing's syndrome with bilateral adrenal lesions
Daniela Guelho 1 , Rui Ferreira 2 , Isabel Paiva 1 , Ana Paula Moreira 2 , Carolina Moreno 1 , Luis Cardoso 1 , Nuno Vicente 1 , Diana Martins 1 , Diana Oliveira 1 , Margarida Balsa 3 , Gracinda Costa 2 & Francisco Carrilho 1
1Endocrinology, Diabetes and Metabolism Department, Coimbra Hospital and University Centre, Coimbra, Portugal; 2Nuclear Medicine Department, Coimbra Hospital and University Centre, Coimbra, Portugal; 3Endocrinology, Diabetes and Nutrition Department, Baixo Vouga Hospital Centre, Aveiro, Portugal.
Introduction: Subclinical Cushing’s syndrome (SCS) is the most frequent endocrine dysfunction found in adrenal incidentalomas. Although adrenalectomy constitutes a therapeutic option for selected cases, the presence of bilateral tumours can difficult the surgical decision.
Objective: Evaluate the utility of 131I-6β-iodomethyl-19-norcholesterol scintigraphy in SCS with bilateral adrenal tumours.
Methods: Retrospective analysis of all patients with SCS and bilateral adrenal lesions submitted to 131I-6β-iodomethyl-19-norcholesterol scintigraphy in our Nuclear Medicine Department. Following suppression with dexamethasone, planar thoracoabdominal scintigraphy, and single photon emission computed tomography (SPECT/CT) images were obtained at 3rd, 5th, and 7th days after i.v. administration of 1 mCi of 131I-6β-iodomethyl-19-norcholesterol.
Results: Five scintigraphy were performed in four women, aged 57.5 years (46–67 years), with SCS and bilateral incidentalomas identified by abdominal CT: at right with a median diameter of 19 mm (17–35 mm) and at left with 18 mm (7–28 mm). All patients presented osteoporosis; two had dyslipidaemia and two had arterial hypertension. Two patients showed radiopharmaceutical uptake at right adrenal with non-visualisation of contralateral gland: both were proposed to adrenalectomy. Histopathological study confirmed the adrenal cortical adenoma. After surgery, a significant improvement of their comorbidities was observed with reduction of anti-hypertensive drugs. Other patient exhibited symmetrical uptake and was maintained on medical treatment. In the fourth patient, both the first scintigraphy and adrenal vein sampling were inconclusive. However, after a second scintigraphy that suggested a hyperfunctioning right adenoma, she was submitted adrenalectomy that confirmed the lesion.
Conclusions: This work suggests a high resolution of the adrenal 131I-6β-iodomethyl-19-norcholesterol scintigraphy, providing a more precise picture of functional structural lesions that crosses the information obtained by CT and hormonal assays. In these patients enabled a more targeted surgical approach, preserving the other adrenal and improving their comorbidities.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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