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*A STUDY OF NORCHOLESTEROL SCINTIGRAPHY VERSUS COMPUTED TOMOGRAPHY IN THE LATERALISATION OF HYPERFUNCTIONING ADRENAL LESIONS
Author(s) -
Sanli E.,
Tan C. K.,
Sidhu S. B.,
Sywak M. S.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04916_6.x
Subject(s) - medicine , hyperaldosteronism , primary aldosteronism , radiology , scintigraphy , adrenalectomy , cushing syndrome , histopathology , nuclear medicine , aldosterone , surgery , pathology , blood pressure
Purpose: Norcholesterol adrenal scintigraphy (Norchol) and computed tomography (CT) are frequently utilised in the investigation of hyperfunctioning adrenal lesions. In primary hyperaldosteronism where venous sampling has been unsuccessful and in Cushing's syndrome these modalities may help in the lateralisation of adrenal pathology. The aim of this study is to compare the accuracy of Norchol scintigraphy with that of high resolution CT in the lateralisation of hyperfunctioning adrenal tumours. Methodology: A prospective study comparing Norchol with CT was performed. Patients with primary hyperaldosteronism and failed venous sampling underwent evaluation with Norchol scintigraphy and 64 slice multidetector CT. Patients with adrenal Cushing's syndrome were also included and similarly evaluated. Imaging results were correlated with histopathology and clinical outcome after surgery. Results: In the period 2004 to 2007, 23 patients underwent Norchol and CT assessment. 20 patients had laparoscopic adrenalectomy and median follow up was 1 yr. Of these 10 had hyperaldosteronism with failed venous sampling and 10 had Cushing's syndrome. In patients with primary hyperaldosteronism Norchol correctly lateralised pathology in only 60% of cases compared to CT which was correct in 70%. In patients with Cushing's syndrome both Norchol and CT were 100% accurate in detecting the site of cortisol excess. Conclusion: In hyperaldosteronism with failed venous sampling Norchol scintigraphy offers no advantage over high resolution CT for lateralisation of pathology. In Cushing's syndrome both Norchol and CT are highly accurate and equivalent.