Academic Journal
Multimodal imaging for adrenal tumor characterization: clinical impact of the 2023 European guidelines-asingle-center retrospective study.
| Title: | Multimodal imaging for adrenal tumor characterization: clinical impact of the 2023 European guidelines-asingle-center retrospective study. |
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| Authors: | Lutz E; Department of Endocrinology, Diabetology and Nutrition, University Hospital of Nancy, Nancy F-54000, France.; Faculty of Medicine of Nancy, University of Lorraine, Nancy F-54000, France., Zaragori T; Meurthe-et-Moselle, CIC 1433, Inserm, Université de Lorraine, CHRU Nancy, Nancy F-54000, France.; Meurthe-et-Moselle, IADI, U1254, Inserm, Université de Lorraine, Nancy F-54000, France., Nominé-Criqui C; Faculty of Medicine of Nancy, University of Lorraine, Nancy F-54000, France.; Department of Digestive, Hepatobiliary and Endocrine Surgery, University Hospital of Nancy, Nancy F-54000, France.; INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, University of Lorraine, Nancy F-54000, France., Marie PY; Faculty of Medicine of Nancy, University of Lorraine, Nancy F-54000, France.; Department of Nuclear Medicine and Nancyclotep Platform, University Hospital of Nancy, Nancy F-54000, France., Klein M; Department of Endocrinology, Diabetology and Nutrition, University Hospital of Nancy, Nancy F-54000, France.; Faculty of Medicine of Nancy, University of Lorraine, Nancy F-54000, France., Scheyer N; Department of Endocrinology, Diabetology and Nutrition, University Hospital of Nancy, Nancy F-54000, France.; Faculty of Medicine of Nancy, University of Lorraine, Nancy F-54000, France.; INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), Faculty of Medicine of Nancy, University of Lorraine, Nancy F-54000, France. |
| Source: | European journal of endocrinology [Eur J Endocrinol] 2026 Oct 05; Vol. 195 (4), pp. 541-548. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: England NLM ID: 9423848 Publication Model: Print Cited Medium: Internet ISSN: 1479-683X (Electronic) Linking ISSN: 08044643 NLM ISO Abbreviation: Eur J Endocrinol Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2023- : Oxford : Oxford University Press Original Publication: Oslo, Norway : Scandinavian University Press, c1994- |
| MeSH Terms: | Adrenal Gland Neoplasms*/diagnostic imaging , Adrenal Gland Neoplasms*/surgery , Adrenal Gland Neoplasms*/pathology , Multimodal Imaging*/methods , Multimodal Imaging*/standards , Practice Guidelines as Topic*/standards, Humans ; Retrospective Studies ; Female ; Middle Aged ; Male ; Aged ; Adrenalectomy ; Adult ; Europe |
| Abstract: | Background: Adrenal lesions are becoming increasingly common with the advent of abdominal imaging. Although mostly benign and nonfunctional, some cases may be malignant or secretory and justify adrenalectomy. The 2023 European guidelines propose a more conservative approach (focused on simple radiological criteria) to limit unnecessary surgery. However, the impact of this strategy on the management of malignant lesions remains to be assessed. Methods: We conducted a single-center retrospective study including all patients who underwent adrenalectomy between 2017 and 2024. The aim was to investigate the potential impact of the new iconographic criteria of the 2023 European recommendations. Patients aged over 18 years with at least one preoperative imaging examination and a histopathology report were included. Results: Among 259 patients, 75% had benign lesions, and 25% had malignant lesions. Based on the 2016 guidelines, 71% of the patients would have undergone surgery, whereas 31% would have undergone surgery according to the 2023 criteria. With respect to malignant lesions, 98% of the patients would have received surgery according to the 2016 criteria, whereas 60% would have received surgery according to the 2023 criteria. The inclusion of hypersecretion increased this rate to 93%, and the addition of complementary imaging ensured the detection of all malignant cases. Conclusions: The 2023 guidelines may substantially reduce unnecessary adrenalectomies for benign lesions. The risk of missing malignant tumors remains low when hormonal evaluation and multimodal imaging (such as MRI and FDG-PET) are used, particularly in indeterminate cases. (© The Author(s) 2026. Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
| Competing Interests: | Conflicts of interest: The authors declare that there are no conflicts of interest that could be perceived as prejudicing the impartiality of the reported research. |
| Contributed Indexing: | Keywords: European recommendations; adrenal gland; adrenalectomy; imaging; tumor |
| Entry Date(s): | Date Created: 20260921 Date Completed: 20261005 Latest Revision: 20261005 |
| Update Code: | 20261006 |
| DOI: | 10.1093/ejendo/lvag179 |
| PMID: | 42766813 |
| Database: | MEDLINE |
| ISSN: | 1479-683X |
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| DOI: | 10.1093/ejendo/lvag179 |