Research Article Open Access Volume 7 • Issue 2 • 1000258 Chemotherapy, an open access journal ISSN: 2167-7700 Open Access Research Article Chemotherapy: Open Access C h e m o t h e r a p y : O p e n A c c e s s ISSN: 2167-7700 Kara et al., Chemotherapy 2018, 7:2 DOI: 10.4172/2167-7700.1000258 *Corresponding author: Pelin Ozcan Kara, Department of Nuclear Medicine, Faculty of Medicine, Mersin University, Mersin, Turkey, Tel: 903242410000; Fax: 903242410098; E-mail: ppelinozcan@gmail.com Received: May 28, 2018; Accepted: June 19, 2018; Published: June 25, 2018 Citation: Kara PO, Zehra Pinar KOC, Kara T, Kaya B, Aksoy T (2018) Is Dual-Time- Point Imaging Necessary for Discrimination of Adrenal Benign Lesions Versus Malignant Masses: A Study Comparing Standard Methods with Dual-Time-Point FDG PET-CT Imaging. Chemotherapy 7: 258. doi:10.4172/2167-7700.1000258 Copyright: © 2018 Kara PO, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Keywords: Adrenal lesions; Malignant; Metastases; Lungs Introduction Te adrenal gland is one of the most common sites of metastases afer the lungs, liver and bone. Discrimination of adrenal benign lesions versus malignant masses is essential, especially in patients with cancer, for choosing the appropriate treatment approach and assessing prognosis. Maximum standardized uptake value (SUVmax) or tumor/ liver (T/L) SUV ratios per se are semiquantitative parameters that refect metabolic activity, but are not specifc markers of malignancies. As the uptake of 2-(18F) fuoro-2-deoxy-D-glucose (FDG) in malignancies is expected to increase over time, dual time point acquisition (DTPI) could be potentially useful in partially overcoming the relatively low specifcity of the SUVmax value. Benign and infamatory lesions tend to maintain stable or reduce SUV over time whereas malignant lesions show higher SUV values. Te impact of DTPI has been assessed in various benign and malignant conditions however the clinical usefulness is not assessed in adrenal lesions [1-3]. Tis retrospective study was designed to investigate the clinical role of PET-CT DTPI method to distinguish benign from malignant adrenal lesions in various cancer patients and to compare the standart methods proposed in the literature such as SUVmax value, T/L SUV ratio, visual analysis. Materials and Methods Patients A total of 60 patients (34 male and 26 female, age range: 25-89, mean: 60.7) were included. Primary malignancies of the patients were demonstrated in Table 1. Patients with adrenal lesions on contrast enhanced (CE) CT imaging were selected. Informed consent was taken from all patients. Patients were grouped as benign adrenal group (I), malignant adrenal group (II) and dual-phase-group (III). Is Dual-Time-Point Imaging Necessary for Discrimination of Adrenal Benign Lesions Versus Malignant Masses: A Study Comparing Standard Methods with Dual-Time-Point FDG PET-CT Imaging Pelin Ozcan Kara 1 *, Zehra Pinar KOC 1 , Taylan Kara 2 , Bugra Kaya 3 and Tamer Aksoy 4 1 Department of Nuclear Medicine, Faculty of Medicine, Mersin University, Mersin, Turkey 2 Department of Radiology, Faculty of Medicine, Mersin University, Mersin, Turkey 3 Department of Nuclear Medicine, Faculty of Medicine, Necmeddin Erbakan University, Turkey 4 Department of Nuclear Medicine, Okmeydani Education and Research Hospital, İstanbul, Turkey Abstract Objectives: This retrospective study was designed to investigate the clinical role of FDG PET-CT, for the evaluation of adrenal lesions and to compare the standart methods with dual-time-point imaging (DTPI) method to distinguish benign from malignant lesions in various cancer patients. Materials and methods: A total of 60 patients with confrmed primary malignancies underwent PET-CT examinations. Of the 60 patients, 79 adrenal lesions (36 benign and 43 malignant adrenal lesions) were shown by CT. Patients were grouped as benign adrenal group (I), malignant adrenal group (II) and dual-phase-group (III). Results: A total of 20 (33%) patients were included in benign adrenal group (Group I) with 28 adrenal lesions. Mean SUVmax value 2.95 were evaluated. All adrenal lesions in Group I had SUVmax value below cut-off 4.2 except 2. A total of 19 (32%) patients were included in malignant adrenal group (Group II) with 22 adrenal lesions. Mean SUVmax value 8.16 were evaluated. All adrenal lesions in Group II had SUVmax value over cut-off 4.2 except 2. A total of 21 (35%) patients were included in dual phase adrenal group (Group III) with 29 adrenal lesions. For malignant adrenal lesions in group III, all of the 21 malign lesions showed increased FDG uptake and SUVmax value in late imaging. Conclusion: Dual time point imaging of PET-CT seems to be very effective especially in adrenal lesions, addition of dual phase study routinely is not necessary and recommented in only indeterminated lesions. Primary lesion No. of patients Lung cancer 36 Gastrointestinal malignancies 4 Malignant melanoma 1 Geitourinary malignancies 4 Brain 1 Breast carcinoma 6 Gynecological Malignancies 3 Head and Neck Primary 1 Primary Surrenal 2 Lymphoma 1 Leiomyosarcoma 1 Table 1: 18F-FDG PET/CT Indications.