Contralateral adrenal suppression on adrenocortical scintigraphy provides good evidence showing subclinical cortisol overproduction from unilateral adenomas

Katabami, Takuyuki; Ishii, Satoshi; Obi, Ryusei; Asai, Shiko; Tanaka, Yasushi

doi:10.1507/endocrj.ej16-0281

Cited by 14 publications

(6 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results suggest that the timing of imaging may be workable, even after 5 days. Furthermore, reports have indicated that the adrenal gland intake rate was correlated with cortisol in patients with subclinical Cushing's syndrome [12]. Although other reports have pointed to correlations between tumor size and intake rate [12], this study did not reveal any correlations between the intake rate of the adrenal cortex and cortisol.…”

Section: Discussioncontrasting

confidence: 83%

Investigation of Cushing’s and subclinical Cushing’s syndromes using adrenocortical scintigraphy

Okada¹,

Matsushita²,

Yamaguchi

2021

Nuclear Medicine Communications

View full text Add to dashboard Cite

Objectives This study assessed the factors related to the intake rate of adrenocortical scintigraphy in Cushing’s and subclinical Cushing’s syndromes, in addition to the methods for differentiating between the two. Methods Clinical findings, blood sampling, and adrenocortical scintigraphy collected at St. Marianna University School of Medicine from 1 January 2010 to 31 December 2019 were used to diagnose initial-onset Cushing’s syndrome and subclinical Cushing’s syndrome, and patients who underwent 131I-NP-59 adrenocortical scintigraphy were used as study subjects. Results A total of 24 (8 male and 16 female) patients were selected. Of them, 7 had Cushing’s syndrome and 17 had subclinical Cushing’s syndrome. A correlation coefficient of −0.474 (P = 0.026) was determined between the intake rate after 7 days and adrenocorticotropic hormone levels. Intake rates after 5 days were 0.51% and 0.31% for Cushing’s and subclinical Cushing’s syndromes, respectively, and were statistically significant (P = 0.03). Intake rates after 7 days were 0.47% and 0.30% for Cushing’s and subclinical Cushing’s syndromes, respectively, and were statistically significant (P = 0.04). Receiver operating characteristic analysis results of Cushing’s and subclinical Cushing’s syndromes for intake rates after 7 days were as follows: cutoff value, 0.248; area under curve, 0.769; and 95% confidence interval, 0.561–0.977. Conclusion There were differences in the intake rates of adrenocortical scintigraphy between the Cushing’s syndrome group and subclinical Cushing’s syndrome group, making it possible to differentiate between the two using the intake rate.

show abstract

Section: Discussioncontrasting

confidence: 83%

Investigation of Cushing’s and subclinical Cushing’s syndromes using adrenocortical scintigraphy

Okada¹,

Matsushita²,

Yamaguchi

2021

Nuclear Medicine Communications

View full text Add to dashboard Cite

show abstract

“…Data regarding the association between radiological characteristics of the adrenal glands and adrenal adenomas and their hormonal functionality are scarce and inconclusive 3,21–26 . Although the quantitative link between cortisol secretion and radiological characteristics has been previously described, these studies did not assess the association between radiological features of AI and metabolic sequelae of ACS 23,27 …”

Section: Introductionmentioning

confidence: 99%

The association between adrenal adenoma size, autonomous cortisol secretion and metabolic derangements

Bleier

Pickovsky

Apter

et al. 2021

Clinical Endocrinology

View full text Add to dashboard Cite

Objective Autonomous cortisol secretion (ACS) is common in patients with adrenal incidentalomas (AI). ACS is associated with increased cardiovascular morbidity and mortality. Data regarding the association between radiological characteristics of adrenal adenomas, their hormonal functionality and metabolic outcomes, are scarce and inconclusive. In this study, we aim to delineate the association between radiological characteristics of AI, ACS and metabolic status. Methods A cross‐sectional study of 77 patients with AI who underwent a comprehensive hormonal evaluation. Radiological assessments were performed by an independent radiologist blinded to the clinical and hormonal phenotype of each case. Linear regression models were used to evaluate the association between post dexamethasone suppression test (DST) cortisol levels, metabolic indices and radiological measurements. Results Mean maximal adenoma diameter was greater in patients with versus without ACS (20.35 ± 6 vs. 27.09 ± 9.3 mm, respectively, p < .01). Maximal adenoma diameter was found to be positively and linearly correlated with post‐DST morning cortisol levels across their entire range (R = .474, p < .01). Linear correlations between maximal adenoma diameter and indices of glycemic control showed a correlation coefficient (R) of .481 and .463 for fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c), respectively, p < .01. When analysis included only patients with ACS, an R = .584 and R = .565 was observed for FPG and HbA1c, respectively (p < .01 for both). The association between maximal adenoma diameter and both FPG and post‐DST morning cortisol intensified in patients with metabolic syndrome. Conclusion There is a quantitative positive mild correlation between AI size and both cortisol autonomy and metabolic parameters.

show abstract

“…In the same study by Ueland, scintigraphy results were concordant with those of AVS only in 13/18 patients . In another study of 22 patients with MACS undergoing scintigraphy, the ratio of the uptake rate of the affected adrenal gland to the contralateral gland (laterality ratio) > 3.07 diagnosed MACS with a sensitivity of 66.7% and specificity of 85.7% . In addition to reported suboptimal accuracy in diagnosing MACS, the role of adrenal scintigraphy is also limited by the lack of availability in certain centers and countries.…”

Section: Approach To Management In Patients With Macsmentioning

confidence: 91%

Modern Management of Mild Autonomous Cortisol Secretion

Delivanis

Athimulam

Bancos

2019

Clin Pharma and Therapeutics

View full text Add to dashboard Cite

Incidentally discovered adrenal tumors are reported in ~ 5% of adults undergoing cross-sectional imaging. Mild autonomous cortisol secretion (MACS) from the adrenal mass is demonstrated in 5-48% of patients with adrenal tumors. The diagnosis of MACS represents a challenge due to limitations of the currently used diagnostic tests, differences in the definitions of the clinically relevant MACS, and heterogeneity in an individual's susceptibility to abnormal cortisol secretion from the adrenal mass. Patients with MACS present with increased risk of cardiovascular risk factors, cardiovascular events, metabolic bone disease, and mortality. Adrenalectomy improves or reverses MACS-associated comorbidities in selected patients. The current review will address diagnostic and management challenges in the care of patients with MACS, discuss data on emerging biomarkers, and suggest future directions in the field of MACS.

show abstract

Contralateral adrenal suppression on adrenocortical scintigraphy provides good evidence showing subclinical cortisol overproduction from unilateral adenomas

Cited by 14 publications

References 18 publications

Investigation of Cushing’s and subclinical Cushing’s syndromes using adrenocortical scintigraphy

Investigation of Cushing’s and subclinical Cushing’s syndromes using adrenocortical scintigraphy

The association between adrenal adenoma size, autonomous cortisol secretion and metabolic derangements

Modern Management of Mild Autonomous Cortisol Secretion

Contact Info

Product

Resources

About