The role of radiologic imaging in the diagnosis of adrenal tumors: a literature review

ABSTRACT
Background and aim. e adrenal tumors are a reasonably common pathology. Radiologic imaging detects an adrenal neoplasm in approximately 4% of the patients incidentally. It is also a valuable tool that assists in determining a diag- nosis. Furthermore, it may facilitate the further investigation and management of the lesion. is article aims to assess imaging features that are characteristic of the most common adrenal tumors.
Materials and methods. A selective search was carried out for relevant studies concerning radiologic imaging of ad- renal adenoma, myelolipoma, pheochromocytoma, carcinoma, metastases, neural crest tumors, lymphoma, hemangi- oma, lymphangioma, and schwannoma. Medline (PubMed), Cochrane Library, SpringerLink and ScienceDirect data- bases were used.
Results. US is helpful for the screening of masses in the suprarenal region. Nevertheless, its ndings have to be veri ed by CT or MRI. e golden standard of assessing adrenal tumors is native CT. ose lesions which present with probable malignant features should be evaluated using dynamic contrast-enhanced CT. Chemical shi MRI is a feasible alterna- tive, especially in lipomatous masses. PET/CT is recommended for patients with large or indeterminate lesions. Conclusion. Adrenal CT protocol is the most reliable technique in the di erentiation of these diverse neoplasms. On the other hand, CS-MRI is indispensable for verifying intratumoral adipose tissue and, consequently, selecting the most appropriate approach to manage the mass. Furthermore, PET/CT permits characterizing indistinctive tumors and their potential metastatic spread.