TY - JOUR T1 - A Clinical Challenge: Endocrine and Imaging Investigations of Adrenal Masses JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 26S LP - 33S DO - 10.2967/jnumed.120.246066 VL - 62 IS - Supplement 2 AU - Anders Sundin AU - Elif Hindié AU - Anca M. Avram AU - Antoine Tabarin AU - Karel Pacak AU - David Taïeb Y1 - 2021/07/01 UR - http://jnm.snmjournals.org/content/62/Supplement_2/26S.abstract N2 - Incidentalomas are reported in 3%–4% of patients who undergo abdominal anatomic imaging, making adrenal mass evaluation a common occurrence. An adrenal mass can be caused by a variety of pathologies, such as benign cortical and medullary tumors, malignant tumors (primary or secondary), cysts, hyperplasia, hemorrhage, or more rarely infection/inflammation processes. Functioning tumors usually have increased hormonal production but they are less common. Regardless of their functional status, some tumors have the potential to behave aggressively. Anatomic and functional imaging together with biologic evaluation play a vital role in adrenal pathology subtyping. Most patients are initially evaluated by CT or MRI, which allows for tumor characterization (to a certain extent) and can rule out malignant behavior based on the absence of tumor growth during longitudinal follow-up. In the remaining patients for whom CT or MRI fail to characterize the pathogenesis of adrenal tumors, the use of specialized molecular imaging techniques should be performed after hormonal screening. This review emphasizes well-established and emerging nuclear medicine imaging modalities and describes their use across various clinical scenarios.AbbreviationsRETrearranged during transfection proto-oncogeneSDHsuccinate dehydrogenaseSDHA, -B, -C, -Dsuccinate dehydrogenase subunits A, B, C, DSDHxsuccinate dehydrogenase subunitsNF1neurofibromin 1MAXmyc-associated factor XTMEM127transmembrane protein 127CYPcytochrome P450 superfamilyARMC5armadillo repeat containing 5PRKAR1Aprotein kinase A regulatory subunit type IA ER -