[Update in adrenal imaging]. / Nouveautés en imagerie surrénalienne.

ABSTRACT

Subclinical adrenocortical adenomas are the most frequent cause of adrenal incidentalomas that are present in 5 % of adult abdominal imaging. Pheochromocytomas and adrenocortical carcinomas, less often encountered tumors, should be diagnosed at an early stage. Unenhanced density with computed tomography below 10 Hounsfield Units (HU) is in favor of an adrenocortical adenoma. Higher unenhanced density should lead to a characterization of the vascularization with contrast-enhanced washout study. Some adrenal masses remain indeterminate after computed tomography scanning. Further diagnostic imaging performed by a multidisciplinary team is required. Progress has been made recently in the characterization of adrenal mass with nuclear medicine imaging. Flurodeoxyglucose positron emission tomography scan is a useful tool to suspect malignancy. Up-to-date imaging allows in the majority of cases to properly diagnose an adrenal tumor.