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Review Article| Volume 59, ISSUE 4, P591-601, July 2021

Incidental Adrenal Nodules

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      References

        • Bovio S.
        • Cataldi A.
        • Reimondo G.
        • et al.
        Prevalence of adrenal incidentaloma in a contemporary computerized tomography series.
        J Endocrinol Invest. 2006; 29: 298-302
        • Young W.F.
        Clinical practice. The incidentally discovered adrenal mass.
        N Engl J Med. 2007; 356: 601-610
        • Fassnacht M.
        • Arlt W.
        • Bancos I.
        • et al.
        Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors.
        Eur J Endocrinol. 2016; 175: G1-G34
        • Song J.H.
        • Chaudhry F.S.
        • Mayo-Smith W.W.
        The incidental adrenal mass on CT: prevalence of adrenal disease in 1,049 consecutive adrenal masses in patients with no known malignancy.
        AJR Am J Roentgenol. 2008; 190: 1163-1168
        • Mayo-Smith W.W.
        • Song J.H.
        • Boland G.L.
        • et al.
        Management of incidental adrenal masses: a white paper of the ACR incidental findings committee.
        J Am Coll Radiol. 2017; 14: 1038-1044
        • Zeiger M.A.
        • Thompson G.B.
        • Duh Q.Y.
        • et al.
        The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons medical guidelines for the management of adrenal incidentalomas.
        Endocr Pract. 2009; 15: 1-20
        • Corwin M.T.
        • Chalfant J.S.
        • Loehfelm T.W.
        • et al.
        Incidentally detected bilateral adrenal nodules in patients without cancer: is further workup necessary?.
        AJR Am J Roentgenol. 2018; 210: 780-784
        • Boland G.W.
        • Goldberg M.A.
        • Lee M.J.
        • et al.
        Indeterminate adrenal mass in patients with cancer: evaluation at PET with 2-[F-18]-fluoro-2-deoxy-D-glucose.
        Radiology. 1995; 194: 131-134
        • Song J.H.
        • Grand D.J.
        • Beland M.D.
        • et al.
        Morphologic features of 211 adrenal masses at initial contrast-enhanced CT: can we differentiate benign from malignant lesions using imaging features alone?.
        AJR Am J Roentgenol. 2013; 201: 1248-1253
        • Kahramangil B.
        • Kose E.
        • Remer E.M.
        • et al.
        A modern assessment of cancer risk in adrenal incidentalomas: analysis of 2219 patients.
        Ann Surg. 2020; https://doi.org/10.1097/SLA.0000000000004048
        • Schieda N.
        • Davenport M.S.
        • Pedrosa I.
        • et al.
        Renal and adrenal masses containing fat at MRI: proposed nomenclature by the society of abdominal radiology disease-focused panel on renal cell carcinoma.
        J Magn Reson Imaging. 2019; 49: 917-926
        • Kenney P.J.
        • Wagner B.J.
        • Rao P.
        • et al.
        Myelolipoma: CT and pathologic features.
        Radiology. 1998; 208: 87-95
        • Schieda N.
        • Al Dandan O.
        • Kielar A.Z.
        • et al.
        Pitfalls of adrenal imaging with chemical shift MRI.
        Clin Radiol. 2014; 69: 1186-1197
        • Shaaban A.M.
        • Rezvani M.
        • Tubay M.
        • et al.
        Fat-containing retroperitoneal lesions: imaging characteristics, localization, and differential diagnosis.
        Radiographics. 2016; 36: 710-734
        • Ranathunga D.S.
        • Cherpak L.A.
        • Schieda N.
        • et al.
        Macroscopic fat in adrenocortical carcinoma: a systematic review.
        AJR Am J Roentgenol. 2020; 214: 390-394
        • Choi Y.A.
        • Kim C.K.
        • Park B.K.
        • et al.
        Evaluation of adrenal metastases from renal cell carcinoma and hepatocellular carcinoma: use of delayed contrast-enhanced CT.
        Radiology. 2013; 266: 514-520
        • Schieda N.
        • Krishna S.
        • McInnes M.D.F.
        • et al.
        Utility of MRI to differentiate clear cell renal cell carcinoma adrenal metastases from adrenal adenomas.
        AJR Am J Roentgenol. 2017; 209: W152-W159
        • Patel J.
        • Davenport M.S.
        • Cohan R.H.
        • et al.
        Can established CT attenuation and washout criteria for adrenal adenoma accurately exclude pheochromocytoma?.
        AJR Am J Roentgenol. 2013; 201: 122-127
        • Boland G.W.
        • Lee M.J.
        • Gazelle G.S.
        • et al.
        Characterization of adrenal masses using unenhanced CT: an analysis of the CT literature.
        AJR Am J Roentgenol. 1998; 171: 201-204
        • Caoili E.M.
        • Korobkin M.
        • Francis I.R.
        • et al.
        Adrenal masses: characterization with combined unenhanced and delayed enhanced CT.
        Radiology. 2002; 222: 629-633
        • Woo S.
        • Suh C.H.
        • Kim S.Y.
        • et al.
        Pheochromocytoma as a frequent false-positive in adrenal washout CT: a systematic review and meta-analysis.
        Eur Radiol. 2018; 28: 1027-1036
        • Adam S.Z.
        • Nikolaidis P.
        • Horowitz J.M.
        • et al.
        Chemical shift MR imaging of the adrenal gland: principles, pitfalls, and applications.
        Radiographics. 2016; 36: 414-432
        • Platzek I.
        • Sieron D.
        • Plodeck V.
        • et al.
        Chemical shift imaging for evaluation of adrenal masses: a systematic review and meta-analysis.
        Eur Radiol. 2019; 29: 806-817
        • Park B.K.
        • Kim C.K.
        • Kim B.
        • et al.
        Comparison of delayed enhanced CT and chemical shift MR for evaluating hyperattenuating incidental adrenal masses.
        Radiology. 2007; 243: 760-765
        • Seo J.M.
        • Park B.K.
        • Park S.Y.
        • et al.
        Characterization of lipid-poor adrenal adenoma: chemical-shift MRI and washout CT.
        AJR Am J Roentgenol. 2014; 202: 1043-1050
        • Israel G.M.
        • Korobkin M.
        • Wang C.
        • et al.
        Comparison of unenhanced CT and chemical shift MRI in evaluating lipid-rich adrenal adenomas.
        AJR Am J Roentgenol. 2004; 183: 215-219
        • Rodacki K.
        • Ramalho M.
        • Dale B.M.
        • et al.
        Combined chemical shift imaging with early dynamic serial gadolinium-enhanced MRI in the characterization of adrenal lesions.
        AJR Am J Roentgenol. 2014; 203: 99-106
        • Sydow B.D.
        • Rosen M.A.
        • Siegelman E.S.
        Intracellular lipid within metastatic hepatocellular carcinoma of the adrenal gland: a potential diagnostic pitfall of chemical shift imaging of the adrenal gland.
        AJR Am J Roentgenol. 2006; 187: W550-W551
        • Lumachi F.
        • Basso S.M.
        • Borsato S.
        • et al.
        Role and cost-effectiveness of adrenal imaging and image-guided FNA cytology in the management of incidentally discovered adrenal tumours.
        Anticancer Res. 2005; 25: 4559-4562
        • Boland G.W.
        • Dwamena B.A.
        • Jagtiani Sangwaiya M.
        • et al.
        Characterization of adrenal masses by using FDG PET: a systematic review and meta-analysis of diagnostic test performance.
        Radiology. 2011; 259: 117-126
        • Hindman N.M.
        • Megibow A.J.
        One-stop shopping: dual-energy CT for the confident diagnosis of adrenal adenomas.
        Radiology. 2020; 296: 333-334
        • Ho L.M.
        • Marin D.
        • Neville A.M.
        • et al.
        Characterization of adrenal nodules with dual-energy CT: can virtual unenhanced attenuation values replace true unenhanced attenuation values?.
        AJR Am J Roentgenol. 2012; 198: 840-845
        • Gnannt R.
        • Fischer M.
        • Goetti R.
        • et al.
        Dual-energy CT for characterization of the incidental adrenal mass: preliminary observations.
        AJR Am J Roentgenol. 2012; 198: 138-144
        • Morgan D.E.
        • Weber A.C.
        • Lockhart M.E.
        • et al.
        Differentiation of high lipid content from low lipid content adrenal lesions using single-source rapid kilovolt (peak)-switching dual-energy multidetector CT.
        J Comput Assist Tomogr. 2013; 37: 937-943
        • Kim Y.K.
        • Park B.K.
        • Kim C.K.
        • et al.
        Adenoma characterization: adrenal protocol with dual-energy CT.
        Radiology. 2013; 267: 155-163
        • Nagayama Y.
        • Inoue T.
        • Oda S.
        • et al.
        Adrenal adenomas versus metastases: diagnostic performance of dual-energy spectral CT virtual noncontrast imaging and iodine maps.
        Radiology. 2020; 296: 324-332
        • Mileto A.
        • Nelson R.C.
        • Marin D.
        • et al.
        Dual-energy multidetector CT for the characterization of incidental adrenal nodules: diagnostic performance of contrast-enhanced material density analysis.
        Radiology. 2015; 274: 445-454
        • Kaza R.K.
        • Raff E.A.
        • Davenport M.S.
        • et al.
        Variability of CT attenuation measurements in virtual unenhanced images generated using multimaterial decomposition from fast kilovoltage-switching dual-energy CT.
        Acad Radiol. 2017; 24: 365-372
        • Remer E.M.
        • Motta-Ramirez G.A.
        • Shepardson L.B.
        • et al.
        CT histogram analysis in pathologically proven adrenal masses.
        AJR Am J Roentgenol. 2006; 187: 191-196
        • Bae K.T.
        • Fuangtharnthip P.
        • Prasad S.R.
        • et al.
        Adrenal masses: CT characterization with histogram analysis method.
        Radiology. 2003; 228: 735-742
        • Clark T.J.
        • Hsu L.D.
        • Hippe D.
        • et al.
        Evaluation of diagnostic accuracy: multidetector CT image noise correction improves specificity of a Gaussian model-based algorithm used for characterization of incidental adrenal nodules.
        Abdom Radiol (NY). 2019; 44: 1033-1043
      1. RadDecisionSupport.com.
        (Available at:) (Accessed May 22, 2020)
        • Glazer D.I.
        • Mayo-Smith W.W.
        Letter to the editor response.
        Abdom Radiol (NY). 2020; https://doi.org/10.1007/s00261-020-02666-5
        • Lee J.M.
        • Kim M.K.
        • Ko S.H.
        • et al.
        Clinical guidelines for the management of adrenal incidentaloma.
        Endocrinol Metab (Seoul). 2017; 32: 200-218
        • Sherlock M.
        • Scarsbrook A.
        • Abbas A.
        • et al.
        Adrenal incidentaloma.
        Endocr Rev. 2020; 41https://doi.org/10.1210/endrev/bnaa008
        • Canu L.
        • Van Hemert J.A.W.
        • Kerstens M.N.
        • et al.
        CT characteristics of pheochromocytoma: relevance for the evaluation of adrenal incidentaloma.
        J Clin Endocrinol Metab. 2019; 104: 312-318
        • Kievit J.
        • Haak H.R.
        Diagnosis and treatment of adrenal incidentaloma. A cost-effectiveness analysis.
        Endocrinol Metab Clin North Am. 2000; 29 (viii-ix): 69-90
        • Chomsky-Higgins K.
        • Seib C.
        • Rochefort H.
        • et al.
        Less is more: cost-effectiveness analysis of surveillance strategies for small, nonfunctional, radiographically benign adrenal incidentalomas.
        Surgery. 2018; 163: 197-204
        • Corwin M.T.
        • Navarro S.M.
        • Malik D.G.
        • et al.
        Differences in growth rate on CT of adrenal adenomas and malignant adrenal nodules.
        AJR Am J Roentgenol. 2019; 213: 632-636
        • Zhao B.
        • James L.P.
        • Moskowitz C.S.
        • et al.
        Evaluating variability in tumor measurements from same-day repeat CT scans of patients with non-small cell lung cancer.
        Radiology. 2009; 252: 263-272