Clinical Value of 18F-FDG PET/CT in Detecting Adrenal Metastasis in Patients with Hepatocellular Carcinoma.

The purpose of this study was to evaluate the accuracy of (18)F-FDG PET/CT scans in detecting adrenal metastasis in liver transplant candidates with hepatocellular carcinoma (HCC). A total of 166 patients diagnosed with HCC received (18)F-FDG PET/CT imaging before liver transplantation. Of these patients, 5 patients (4 males, 1 female; median age: 51.2 y, range: 33-61 y) were found to have suspected adrenal metastases and were included in this study. Two cases (Cases 1 and 5) underwent an (18)F-FDG PET/CT scan at the initial stage, 3 cases (Cases 2-4) underwent an (18)F-FDG PET/CT scan for restaging, and one case (Case 5) underwent a second (18)F-FDG PET/CT scan for evaluating treatment response. Among the 8 lesions, there was one false-negative metastatic lesion (Lesion 4, Case 3) and one false-positive adrenal gland lesion (Lesion 7, Case 5) when compared with either histopathologic reports or established clinical and imaging follow-up results. In general, (18)F-FDG PET/CT scans have limitations that make it difficult to distinguish between malignant and benign lesions in adrenal glands that are based only on quantitative values measured using the (18)F-FDG PET/CT scan.