19-iodocholesterol and Adrenal-Gland-Diseases

Topics: 19-Iodocholesterol; 3-Iodobenzylguanidine; Adosterol; Adrenal Gland Diseases; Cushing Syndrome; Humans; Hyperaldosteronism; Hyperparathyroidism; Iodobenzenes; Parathyroid Diseases; Radioisotopes; Radionuclide Imaging; Thallium

Topics: 19-Iodocholesterol; Adrenal Cortex Neoplasms; Adrenal Gland Diseases; Adrenal Glands; Adrenocortical Adenoma; Cushing Syndrome; Diagnosis, Differential; Female; Humans; Hydrocortisone; Middle Aged; Radionuclide Imaging; Tomography, X-Ray Computed; Urination Disorders

Adrenocortical scintigraphy with iodine 131-19-iodocholesterol or selenium 75-6-selenomethylcholesterol was performed in 94 patients with proven or suspected adrenal disease. According to the final diagnosis, 36 patients suffered from primary aldosteronism, 33 from Cushing's syndrome, 8 from low renin hypertension, 6 from nonfunctioning adrenal tumour, 4 from simple obesity, 3 from adrenal metastases, 1 from congenital adrenal hyperplasia, 1 from virilizing adrenal adenoma, 1 from extraadrenal phaeochromocytoma, 1 from ganglioneuroma. Surgical confirmation of the diagnosis was obtained in most cases. With a few exceptions, the scintigraphy results were consistent with the final diagnosis. The two tracers were equally effective adrenal scanning agents. Tracer concentration was measured in a number of surgical specimens, mostly from patients given selenocholesterol. This measurement in surgical samples has not been reported in previous studies with this agent. The results provided a direct validation of uptake measurements in vivo. The data, collected over a 17-year period, demonstrate that despite the advent of new imaging techniques, adrenal scintigraphy that gives both functional and morphologic information still has an important role in the diagnosis of adrenal disease.

Topics: 19-Iodocholesterol; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Cholesterol; Cushing Syndrome; Humans; Hyperaldosteronism; Iodine Radioisotopes; Organoselenium Compounds; Radionuclide Imaging; Retrospective Studies; Selenium; Selenium Radioisotopes

To determine the efficacy of 131I-6-beta-iodomethylnorcholesterol (NP-59) adrenal scintigraphy in distinguishing benign from malignant euadrenal masses.. Case series of patients with incidentally discovered unilateral, euadrenal masses.. Referral-based nuclear medicine clinics at university and affiliated Veterans Administration medical centers.. Consecutive sample of 119 euadrenal patients with unilateral adrenal masses discovered on computed tomographic (CT) scans for reasons other than suspected adrenal disease.. Adrenal scintiscans done using 1 mCi of NP-59 intravenously, and gamma camera imaging 5 to 7 days later.. Mean lesion diameter was 3.3 +/- 1.9 cm (SD) (95% CI: 2.9 to 3.6 cm). In 76 patients, NP-59 uptake lateralized to the abnormal adrenal seen on CT scans (concordant imaging), and in all of these patients, a diagnosis of adenoma was made by needle-aspiration biopsy, adrenalectomy, or extended follow-up with repeat CT scans that were unchanged at 6 months or later. Twenty-six patients had absent or markedly reduced NP-59 uptake in the glands identified as abnormal on CT scans (discordant imaging). These adrenal masses proved to be metastatic malignancies in 19 patients, primary adrenal neoplasms other than adenoma in 4, and adrenal cysts in 3. Bilateral, symmetric accumulation of NP-59 was seen in 17 patients, in whom the adrenal masses were shown to be metastatic malignancies in 2, and adenomas in 6 (the lesions in these cases being 2 cm or less in diameter), and lesions not truly involving the adrenal in the rest (periadrenal metastases in 4 and pseudoadrenal masses in 5). Sensitivity was 76% (26 of 34 patients; CI, 58% to 88%); specificity, 100% (85 of 85 patients; CI, 95% to 100%), and accuracy, 93% (111 of 119 patients: CI, 88% to 98%).. Functional NP-59 scintigraphy can be used to accurately and noninvasively characterize many euadrenal masses; concordance of CT and NP-59 scans can be used to exclude the presence of a malignancy or other space-occupying adrenal lesion.

Topics: 19-Iodocholesterol; Adenoma; Adolescent; Adrenal Cortex; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adult; Aged; Aged, 80 and over; Cholesterol; Cysts; Diagnosis, Differential; Female; Humans; Iodine Radioisotopes; Male; Middle Aged; Predictive Value of Tests; Radionuclide Imaging; Tomography, X-Ray Computed

The exact localization of adrenal lesions can be achieved by noninvasive procedures. Whereas radiological methods reflect morphological changes, scintigraphy of adrenal cortex and medulla depends on function. - Radiolabeled 6 beta-methyl-19-norcholesterol is used for adrenocortical scintigraphy in primary aldosteronism, Cushing's syndrome and hyperandrogenism. By dexamethasone suppression a correct classification of adrenocortical lesions by scintigraphy can be observed in about 89% with a specificity of 86%. 123-I- and 131-I-metaiodobenzylguanidine is used for specific scintigraphy of the adrenal medulla. This method is a safe and reliable method for localization of adrenal and extraadrenal pheochromocytomas.

Topics: 19-Iodocholesterol; 3-Iodobenzylguanidine; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Cholesterol; Cushing Syndrome; Dexamethasone; Humans; Hyperaldosteronism; Iodobenzenes; Pheochromocytoma; Radionuclide Imaging; Selenium; Succimer; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid

The diagnostic usefulness of adrenal imaging with 131I-iodocholesterol (NP-59) is now well established. In order to correlate histopathology with the adrenal scan the authors examine and report their experience in 37 patients with surgically proven adrenal lesions or pituitary adenomas. This series included 24 patients with Cushing's syndrome: 14 caused by benign adrenal adenoma and 10 due to bilateral pituitary-ACTH-dependent adrenocortical hyperplasia. Ten patients with primary aldosteronism were submitted to surgery which confirmed the presence of aldosterone-producing adrenal adenomas. Two women with hyperandrogenism (due to virilizing ovarian tumors) had normal adrenals but the ovarian stromal luteoma markedly concentrated the iodocholesterol while the arrhenoblastoma did not. A patient with adrenal hematoma is also included in this report. The overall histopathological correlation with the radiocholesterol scintiscan yields an accuracy in our series of 97% (36/37). The false-negative adrenal scan (also missed by other non-invasive techniques) occurred in a patient with an aldosterone-producing adrenal adenoma measuring 1.0 X 1.5 cm.

Topics: 19-Iodocholesterol; Adenoma; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adult; Cholesterol; Cushing Syndrome; Female; Hematoma; Humans; Hyperaldosteronism; Iodine Radioisotopes; Male; Radionuclide Imaging; Virilism

Topics: 19-Iodocholesterol; Adrenal Gland Diseases; Adrenal Glands; Animals; Binding, Competitive; Carboxylic Ester Hydrolases; Cholesterol; Cholesterol Esters; Female; Humans; In Vitro Techniques; Iodine Radioisotopes; Rats; Sterol Esterase; Substrate Specificity