19-iodocholesterol and Cushing-Syndrome

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

The aim of this study was three-fold: 1) to quantify [131I]-6beta-iodomethyl-norcholesterol ([131I]-NP-59) adrenal uptake trend in patients with incidentalomas, 2) to identify a specific uptake trend (TREND) capable of characterising pre-clinical Cushing syndrome (PC-CS) patients, 3) to assess the clinical availability of TREND as a prognostic factor of late clinical outcome in a cohort of patients with bilateral adrenal adenomas.. Fifty-seven consecutive patients were examined using three-head SPECT at 24, 48, 72 hours following intravenous injection of [131I ]-NP-59. On the basis of the absence or presence of hormonal abnormalities, the selected population was classified as GR1 or GR2, respectively. Adrenal glands were classified into 4 groups taking into account both the patient group (GR1, GR2) and the presence (+) or absence (-) of the adenoma (AD) on CT scan. Using ROI technique, adrenal-liver uptake ratio (A/L) was estimated bilaterally at 24, 48 and 72 hours. For each adrenal group, mean [131I]-NP-59 uptake trends were derived.. TREND was significantly different between GR1/AD+ and GR2/AD+. Among GR2/AD+ patients, TREND correctly identified PC-CS with a global accuracy of 74%. Two patients with bilateral incidentaloma developed an overt CS. In both patients, TREND correctly identified the hyperfunctioning adrenal, thus permitting an effective sparing adrenalectomy.. TREND seems to be a parameter which closely reflects adrenal physiological behaviour, especially in the case of bilateral adrenal involving. The possibility to quantify even contralateral adrenal uptake as standardised index provides additional useful information about normal adrenal parenchyma and, indirectly, about adenoma functional autonomy.

Topics: 19-Iodocholesterol; Adenoma; Adrenal Cortex Neoplasms; Cushing Syndrome; Female; Humans; Image Interpretation, Computer-Assisted; Male; Metabolic Clearance Rate; Middle Aged; Radiopharmaceuticals; Reference Values; Reproducibility of Results; Sensitivity and Specificity; Tomography, Emission-Computed, Single-Photon

The goal of this study was to evaluate the clinical reliability of the (131)I-6 beta-iodomethyl-norcholesterol ((131)I-NP-59) uptake semiquantitative evaluation method we propose for the characterization of adrenocortical masses in a selected population of patients with disease clinically classified as subclinical (SC) and preclinical (PC) Cushing's syndrome (CS) according to Reincke's definition.. Forty-seven consecutive patients with incidentally discovered unilateral adrenal masses were examined by a triple-head SPECT system after intravenous injection of (131)I-NP-59. Abdominal SPECT was performed at 24, 48, 72, and, in selected cases, 96 h after tracer injection. Connected with adrenals and liver, a standard elliptic region of interest (ROI) was manually drawn, taking care to avoid the gallbladder region. The adrenal ROI integral count, obtained by summing the 24-, 48-, and 72-h counting values, was normalized by the hepatic integral count. Subsequently, the adrenal percentage of relative uptake (UPT%) was computed.. Discriminant analysis was performed on the variables UPT%, adrenocorticotropic hormone (ACTH) serum concentration, and CT mass dimension (CTMD) to determine the variable, or combination thereof, best discriminating between the SC-CS and PC-CS groups. Compared with both ACTH and CTMD variables, univariate analysis confirmed the UPT% variable as the most significant to discriminate between these 2 clinical groups. In fact, UPT% alone correctly classified 8 of 9 patients in the SC-CS group and 20 of 22 patients in the PC-CS group with 95% positive and 80% negative predictive values and with overall accuracy, sensitivity, and specificity equal to 90%, 91%, and 89%, respectively. When all 3 variables were submitted to stepwise discriminant analysis, the derived classification matrix, after cross-validation, correctly classified 9 of 9 patients in the SC-CS group and 18 of 22 patients in the PC-CS group with 100% positive and 69% negative predictive values and with overall accuracy, sensitivity, and specificity equal to 87%, 82%, and 100%, respectively.. According to these initial results, use of the proposed semiquantitative approach associated with both laboratory screening for cortisol production and CTMD measure seems to be able to increase the clinical diagnostic accuracy of PC-CS. This approach could be used in the follow-up of adrenal mass function every time hormonal or clinical features are suggestive of adrenocortical hyperfunction.

Topics: 19-Iodocholesterol; Adrenal Cortex; Adrenal Gland Neoplasms; Adult; Aged; Cushing Syndrome; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Tomography, Emission-Computed, Single-Photon

Topics: 19-Iodocholesterol; Adenoma; Adrenal Cortex Neoplasms; Adrenocortical Adenoma; Adult; Aged; Asymptomatic Diseases; Cushing Syndrome; Female; Humans; Hydrocortisone; Limit of Detection; Male; Middle Aged; Pituitary-Adrenal Function Tests; Radionuclide Imaging; Retrospective Studies

Management of subclinical Cushing's syndrome (SCS) remains controversial; it is not possible to predict which patients would benefit from adrenalectomy. In the present study we aimed to evaluate the role of adrenocortical scintigraphy (ACS) in the management of patients with SCS.. The medical records of 33 consecutive patients with adrenal "incidentaloma" and proven or suspected SCS who underwent (131)I-19-iodocholesterol ACS between 2004 and 2010 were reviewed. Sixteen underwent laparoscopic adrenalectomy (surgical group-S-group) and 17 were medically managed (medical group-M-group). Follow-up evaluation was obtained by outpatient consultation.. Overall 25 patients (15 in the S-group and 10 in the M-group) had concordant unilateral uptake at ACS (ACS+). In the S-group, the mean follow-up duration was 30.9 ± 16.1 months and, irrespective of the presence of hormonal diagnosis of SCS, in patients who were ACS+ adrenalectomy resulted in a significant increase in HDL cholesterol and decreases in body mass index, glycemia, and blood pressure (BP). One patient reduced antihypertensive medication and three others were able to discontinue it altogether. Prolonged postoperative hypoadrenalism (PH) occurred in 14 patients in the S-group. The overall accuracy in predicting PH was 93.7 % for ACS and 68.7 % for laboratory findings. In the M-group, the mean follow-up duration was 31.5 ± 26.3 months and no patient developed overt Cushing's syndrome, although ACS+ patients experienced a worsening in glycemia and diastolic BP.. Adrenal scintigraphy seems the most accurate diagnostic test for SCS. It is able to predict the metabolic outcome and the occurrence of PH, identifying the patients who could benefit from adrenalectomy irrespective of hormonal diagnosis.

Topics: 19-Iodocholesterol; Adrenal Gland Neoplasms; Adrenal Insufficiency; Adrenalectomy; Adult; Age Factors; Aged; Analysis of Variance; Cohort Studies; Cushing Syndrome; Female; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Predictive Value of Tests; Radionuclide Imaging; Retrospective Studies; Risk Assessment; Role; Severity of Illness Index; Sex Factors; Treatment Outcome

Topics: 19-Iodocholesterol; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Asymptomatic Diseases; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Incidental Findings; Iodine Radioisotopes; Middle Aged; Neoplasms, Multiple Primary; Radionuclide Imaging; Radiopharmaceuticals; Tomography, X-Ray Computed; Watchful Waiting

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

The case of a 49 yr old alcoholic women with clinical and laboratory findings that suggested a Cushing syndrome is presented. The functional tests showed cortisol suppression greater than 50% of the basal value with 8 mg of dexamethasone and no response in the combined dexamethasone/desmopressin test. Pituitary Nuclear Magnetic Resonance (NMR) was negative, Abdominal Computed Axial Tomography suggested hyperplastic adrenal glands; adrenal nodules were not found in the NMR. Pituitary or hipothalamic Cushing with secondary autonomous micronodular adrenal hyperplasia was suspected. Norcholesterol-I131 SPECT scintigraphy under dexamethasone suppression demonstrated a functional adrenal hyperplasia which was hystologically confirmed.

Topics: 19-Iodocholesterol; Adrenal Cortex; Adrenal Glands; Cushing Syndrome; Female; Humans; Middle Aged; Pituitary Gland; Tomography, Emission-Computed, Single-Photon

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 assess the efficacy of 131I-6-beta-iodomethylnorcholesterol scintigraphy in the adrenocorticotropic hormone-independent Cushing syndrome and to compare this with computed tomography.. Retrospective analysis of case series from 1977 to 1987.. Referral to the Division of Nuclear Medicine at a tertiary-care university medical center.. Twenty-four patients with a pathologically-confirmed diagnosis of the adrenocorticotropic hormone-independent Cushing syndrome had 131I-6-beta-iodomethylnorcholesterol scintigraphy and, in most cases, computed tomography.. Using 131I-6-beta-iodomethylnorcholesterol scintigraphy, adenomas were accurately seen as focal, unilateral tracer uptake in 14 of 14 patients. In carcinoma, the classic scintigraphic pattern of bilateral nonvisualization was observed in 3 of 4 patients, with ipsilateral uptake of tracer in 1 patient with a histologically well-differentiated malignancy. Computed tomography done during the same interval depicted abnormal adrenals in all cases of adenoma and carcinoma. In cortical nodular hyperplasia, however, computed tomography identified abnormal pairs of adrenals in only one of four cases studied, whereas scintigraphy showed typical patterns of bilateral increased uptake in all of the cases.. 131I-6-beta-iodomethylnorcholesterol scintigraphy accurately shows the location and nature of adrenal dysfunction in the adrenocorticotropic hormone-independent Cushing syndrome and may be particularly useful in identifying the bilateral adrenal involvement in cortical nodular hyperplasia.

Topics: 19-Iodocholesterol; Adenoma; Adrenal Cortex; Adrenal Cortex Diseases; Adrenal Cortex Neoplasms; Carcinoma; Cholesterol; Cushing Syndrome; Evaluation Studies as Topic; Female; Humans; Hyperplasia; Iodine Radioisotopes; Male; Radionuclide Imaging; Retrospective Studies; Tomography, X-Ray Computed

A case is described without clinical and hormonal data about Icenko-Cushing syndrome, with a scintigraphy of adrenals demonstrating the image, characteristic for corticosteroma (decompensated node). The most probable explanation of the finding is that the tumour is with restricted secretory possibilities and secrets mainly biologically inactive hormones, and furthermore it is not with an autonomous, but ACTH-dependent hormonal production.

Topics: 19-Iodocholesterol; Adenoma; Adrenal Cortex Hormones; Adrenal Cortex Neoplasms; Cholesterol; Cushing Syndrome; Female; Humans; Iodine Radioisotopes; Middle Aged; Radionuclide Imaging

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

To evaluate the current use of adrenalectomy in the treatment of Cushing's disease, we reviewed seven consecutive patients who have undergone adrenalectomy for Cushing's disease at this medical center during 1983 to 1984. Seventy-one percent (5/7) had pituitary, or type I, Cushing's disease, while 29% (2/7) had adrenal, or type II, Cushing's disease from either an adenoma or an adrenocortical carcinoma. Presenting signs and symptoms, either initially or at the time of recurrence, were typical of Cushing's syndrome. Four of five patients with type I disease had recurrent disease after transphenoidal hypophysectomy, bilateral adrenalectomy, or unilateral adrenalectomy. In three of five patients, medical therapy of hypercortisolism was abandoned because of adverse side effects. Preoperative evaluation in all patients included cortisol and ACTH levels, dexamethasone suppression tests, and computerized tomography (both abdominal and head). In patients with a prior history of adrenalectomy, radiocholesterol scans were also performed and were useful. Angiographic procedures were not required in these patients. In patients with type I disease, posterior operative approaches were used. In patients with type II disease, an anterolateral approach was used. Posterolateral incisions are preferred over Hugh-Young incisions and provide better exposure with a reduced risk of poor wound healing. Morbidity and mortality included one death and three nonhealing wounds. In the six surviving patients, symptoms resolved with variable frequency. Findings suggestive of Nelson's syndrome (hyperpigmentation) have occurred in two patients; serial computerized tomographic scans fail to reveal evidence of pituitary tumors. We conclude that adrenalectomy remains an essential form of therapy for patients with Cushing's syndrome caused by adrenal tumors or recurrence after previous surgery. The response to the operation is generally good, but long-term surveillance is required for the development of Nelson's syndrome.

Topics: 19-Iodocholesterol; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Aged; Cushing Syndrome; Dexamethasone; Female; Follow-Up Studies; Humans; Hydrocortisone; Iodine Radioisotopes; Postoperative Complications; Radionuclide Imaging; Reoperation; Tomography, X-Ray Computed

The results of scintigraphy in 29 patients with Cushing's syndrome were evaluated. It was possible to separate bilateral hyperplasia from unilateral abnormality. In cases of unilateral abnormality correct localization of the tumour was accomplished and it was possible to visualize adrenocortical carcinoma. The many advantages of adrenal scintigraphy are listed and it is concluded that adrenal scintigraphy is the best means of investigation to differentiate between ACTH-dependent and ACTH-independent Cushing's syndrome.

Topics: 19-Iodocholesterol; Adenoma; Adrenal Gland Neoplasms; Adrenal Glands; Adrenal Hyperplasia, Congenital; Adrenocorticotropic Hormone; Adult; Aged; Carcinoma; Cushing Syndrome; Female; Humans; Iodine Radioisotopes; Male; Middle Aged; Radionuclide Imaging

Thirty-three adrenal scintigrams in 30 patients were reviewed to determine the utility of this noninvasive imaging technique. It was found to be very accurate in distinguishing bilateral from unilateral hyperfunction in patients who have clinical and biochemical evidence of adrenal cortical hyperfunction. The technique proved correct in 12 of 12 cases of Cushing's syndrome and 14 of 19 cases of hyperaldosteronism. Specific clinical questions were also answered in three miscellaneous cases.

Topics: 19-Iodocholesterol; Adrenal Glands; Adult; Aged; Cushing Syndrome; Female; Humans; Hyperaldosteronism; Male; Middle Aged; Radionuclide Imaging

Since Cushing's disease was delineated as a distinct entity, a wide array of therapeutic modalities has been employed to treat its symptoms, which are primarily the result of hypercortisolism. With the advent of pituitary polytomography and the concept of microadenomas, a wave of enthusiasm has developed in recent years in favor of transsphenoidal microdissection. In a recent national survey, however, one third of 30 endocrinologists reported cure rates below 60% and, according to several respondents, recurrence was a serious problem at 50% or greater incidence. We report on four patients treated by bilateral adrenalectomy and autotransplantation. They were weaned off all corticosteroid medication for up to 6 years. Two of the four patients have demonstrable iodocholesterol uptake at the site of autotransplantation. We also report on three additional patients who are taking reduced doses of cortisone. All seven patients have no demonstrable iodocholesterol uptake in the adrenal fossae or other possible ectopic sites. We believe that bilateral adrenalectomy with autotransplantation is a worthy alternative in the long-term treatment of Cushing's disease.

Topics: 19-Iodocholesterol; Adolescent; Adrenal Cortex Hormones; Adrenal Glands; Adrenalectomy; Adult; Cushing Syndrome; Female; Humans; Male; Middle Aged; Transplantation, Autologous

Referral patterns from internists to departments of nuclear medicine or radiology are important determinants of whether adrenal glands are imaged by computed tomography (CT) or by radioisotope scintigraphy. To assist clinicians in making an informed choice, computed tomographic scans were compared with isotope scintigrams using 131I-19-iodocholesterol (19-IC) and 131I-6 beta-iodomethyl-19-norcholesterol (NP-59). In general, imaging techniques serve to localize diseases that are diagnosed on the basis of biochemical tests of adrenal function. Computed tomographic scanning and NP-59 scanning are of comparable diagnostic accuracy. Both are superior to 19-IC scanning in the diagnosis of Cushing's syndrome and primary aldosteronism. Computed tomographic scanning is faster and less expensive, and involves lower radiation doses to the patient than scintigraphy. Adrenocortical isotope scanning as a routine procedure has been superseded by computed tomographic scanning at the Mayo Clinic.

Topics: 19-Iodocholesterol; Adosterol; Adrenal Cortex; Adrenal Cortex Diseases; Adrenal Cortex Neoplasms; Adult; Aged; Cushing Syndrome; Female; Humans; Hyperaldosteronism; Male; Middle Aged; Radionuclide Imaging; Tomography, X-Ray Computed

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; Adosterol; Adrenal Glands; Adult; Aged; Cholesterol; Cushing Syndrome; Evaluation Studies as Topic; Female; Humans; Hyperaldosteronism; Infant; Iodine Radioisotopes; Male; Middle Aged; Radionuclide Imaging; Sterols

Topics: 19-Iodocholesterol; Adrenal Glands; Animals; Anticholesteremic Agents; Cholesterol; Cushing Syndrome; Drug Combinations; Drug Evaluation; Drug Evaluation, Preclinical; Female; Humans; Iodine Radioisotopes; Male; Middle Aged; Radionuclide Imaging; Rats; Saponins; Time Factors

Uptake measurements and visualization of the adrenal glands were performed using 131I-19-iodocholesterol in ten healthy subjects and fourteen patient suffering from Cushing's syndrome (nine hyperplasias and five adenomas). The normal range in healthy subjects (average uptake value +/- 2 SD) is 0.12-0.27% for both adrenals. In patients with Cushing's syndrome the uptake values ranged from 0.321 to 1.497%. Normal bilateral images were obtained in all the healthy subjects as well as in eight of the patients with hyperplasia, whilst the remaining patient with hyperplasia showed distinctly enlarged glands. In contrast, an image of the diseased side only was obtained in patients with adrenal adenomas. We conclude that radiocholesterol studies in Cushing's syndrome allow confirmation of the diagnosis, definition of the pathophysiologic type of disease and lateralization of adrenal adenomas.

Topics: 19-Iodocholesterol; Adolescent; Adrenal Glands; Adult; Aged; Cholesterol; Cushing Syndrome; Female; Humans; Iodine Radioisotopes; Male; Middle Aged; Radionuclide Imaging

Topics: 19-Iodocholesterol; Adolescent; Adrenal Cortex Neoplasms; Adrenocortical Hyperfunction; Adult; Cushing Syndrome; Female; Humans; Iodine Radioisotopes; Male; Middle Aged; Radiography; Radionuclide Imaging

Topics: 19-Iodocholesterol; Adolescent; Adrenal Glands; Adult; Child; Cushing Syndrome; Female; Humans; Hyperaldosteronism; Iodine Radioisotopes; Male; Middle Aged; Photography; Radionuclide Imaging

Topics: 19-Iodocholesterol; Adrenal Gland Neoplasms; Adrenal Glands; Adult; Aged; Animals; Cushing Syndrome; Female; Humans; Hyperaldosteronism; Iodine Radioisotopes; Male; Middle Aged; Pheochromocytoma; Rabbits; Radionuclide Imaging

Adrenal scintiscanning and venography with sampling of adrenal venous blood are valuable methods to localize adrenal cortical lesions of Cushing's syndrome and primary aldosteronism. Adrenal scintiscanning with dexamethasone suppression is most useful in differentiating adenoma from hyperplasia of primary aldosteronism.

Topics: 19-Iodocholesterol; Adrenal Cortex Neoplasms; Adrenal Glands; Cholesterol; Cushing Syndrome; Humans; Hyperaldosteronism; Phlebography; Radionuclide Imaging

Topics: 19-Iodocholesterol; Adrenal Gland Neoplasms; Adrenal Glands; Adult; Animals; Cholesterol; Cushing Syndrome; Female; Humans; Iodine Radioisotopes; Male; Middle Aged; Radionuclide Imaging; Time Factors

Seven patients with Cushing's syndrome secondary to adrenocortical tumors were studied using 131I-19-iodocholesterol. The diagnosis of all cases were verified histologically. In three cases with adenoma the uptake of the tracer was in the tumor only, while the two patients with adrenocortical carcinoma failed to show adrenal accumulation of the labelled compound. In two patients there was a hyperplasia-like scintigraphic pattern, while the stimulation and suppression biochemical tests suggested adrenal tumor. One of these cases was verified as a mixed form (adenoma plus hyperplasia), and the tumor bearing gland was significantly larger on the scan which helped the preoperative localization. In the other case, verified as bilateral multiple adrenocortical adenomas, the autonomus function of both adrenals was proved by dexamethasone suppression scanning. It seens reasonable to use the latter as an adunctive diagnostic procedure in patients where there is a discrepancy between the standart scintiscan and the biochemical indexes of adrenal hyperfunction.

Topics: 19-Iodocholesterol; Adenoma; Adrenal Cortex; Adrenal Cortex Neoplasms; Carcinoma; Cushing Syndrome; Humans; Hyperplasia; Iodine Radioisotopes; Radionuclide Imaging