ECE2024 Eposter Presentations Adrenal and Cardiovascular Endocrinology (155 abstracts)
Adrenal specific functional imaging with 123I-IMAZA for non-invasive diagnostic evaluation of TART - a case series
Stefanie Hahner 1 , Schirbel Andreas 2 , Schlötelburg Wiebke 2 , Carmina Teresa Fuss 1 , Ann-Christin Welp 3 , Matthias Auer 3 , Christian Lottspeich 3 , Britta Heinze 1 & Nicole Reisch 3
1University Hospital Würzburg, Division of Endocrinology and Diabetology, Würzburg; 2University Hospital Würzburg, Department of Nuclear Medicine, Würzburg; 3LMU University Hospital, Department of Medicine IV, Munich
Background: Distinction of benign testicular adrenal rest tumours (TART) and potentially malign Leydig cell tumors (LCT) is challenging but important to prevent unnecessary surgery of TART. Ultrasound or magnetic resonance imaging can reliably detect but not distinguish between both tumour entities.
Methods: Functional imaging results using the specific CYP11B1/2-inhibitor 123I-IMAZA were investigated in seven adult male patients with classic congenital adrenal hyperplasia and incidentally detected testicular masses and in one patient with seminoma. Planar whole body images and in part additional SPECT images were acquired 4 hours after injection of 130-180 MBq 123I-IMAZA. Uptake was compared with testicular uptake in 20 males receiving 123I-IMAZA imaging for other adrenal diseases. Operated testicular lesions were stained for expression of CYP11B1 and 2.
Results: In four cases, scintigraphy showed significant scrotal and adrenal uptake with depiction of even small testicular masses below one cm of diameter. In these patients, no surgical intervention was performed. In two patients with missing tracer uptake, tumour resection showed a Leydig cell tumour not expressing CYP11B. In one, we suspect low detection limit of scintigraphy being responsible for missing tracer uptake. As this patient had very small and for many years known and stable tumour, the likelihood of benign TART was extremely high and surgical intervention was not performed.
Conclusion: This is a unique, first time report of adrenal specific functional imaging for non-invasive diagnostic evaluation of TART.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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