Endocrine Abstracts

Adrenal cortex scintigraphy has been used as early as in the 1970s, however, in recent years, it has been a rarely performed and unappreciated examination. In fact, this examination does not provide a perfect view on morphology of adrenal glands, however it provides an assessment of the examined tumor’s function. The aim of this work is to present our experience with adrenal cortex scintigraphy in assessment of adrenal tumors.

We present a series of 50 Iodomethyl-norcholesterol (NP-59) scintigraphies. The indications for examination were: subclinical hypercortisolemia in patients with bilateral adrenal tumors (32 cases), primary hyperaldosteronism (eight cases), uncertainty in assessment of cortex function (‘border results’ of hormonal investigations) (six cases) and assessment after the surgery of adrenal cancer (four cases). We used two different protocols, depending of assessed adrenal function (without dexametasone if hypercortisolemia was present, with dexamethasone in assessment of hyperaldosteronism).

Scintigraphy showed exclusive or predominant unilateral tracer uptake in 23 of 32 patients with hypercortisolemia. In all these patients after the adrenalectomy of the dominant gland, transient secondary adrenal insufficiency was observed, confirming the proper choice of the operating side. The scintigraphy in eight patients with primary hyperaldosteronism showed unilateral tracer uptake in four subjects. These patients have already been operated with clinical and biochemical benefits. The other four patients (tumors without uptake) are treated pharmacologically with good results. In six patients with ‘border results’ of hormonal investigations there was no tracer uptake after the dexamethasone, so their tumors were classified as non-secreting and the further observation until now confirms this statement. Finally, in one of four patients after the adrenalectomy due to adrenal cancer scintigraphy revealed a very small fragment of adrenal tissue, missed in the operated area.

We concluded that adrenal scintigraphy can be a useful method for functional assessment of various adrenal tumors.