{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T12:12:33Z","timestamp":1764936753373},"reference-count":15,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,3,26]],"date-time":"2015-03-26T00:00:00Z","timestamp":1427328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,3,26]],"date-time":"2015-03-26T00:00:00Z","timestamp":1427328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although 18F\u2010fluorodeoxyglucose (FDG) positron emission tomography combined with computed tomography (PET\/CT) is a potentially powerful, non\u2010invasive imaging tool in differentiating adrenal metastasis from benign disease, some adenomas also exhibit high FDG uptake, therefore mimicking metastasis (i.e., false positives). We aimed to evaluate the accuracy of FDG\u2010PET\/CT based exclusively on histology and to identify risk factors for adrenal metastasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among the 289 consecutive patients who underwent adrenalectomy, 39 (78.0 %) patients had suspected solitary adrenal metastasis and had a positive preoperative FDG\u2010PET\/CT. The FDG\u2010PET\/CT findings were correlated with the histology of the excised adrenal gland. To identify risk factors for adrenal metastasis, characteristics were compared between patients with histologically proven adrenal metastasis and those without. Youden\u2019s index was used to calculate the optimal cut\u2010off value for predicting adrenal metastasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Histology of the excised adrenal tumor confirmed adrenal metastasis in 28\/39 (71.8 %) patients while non\u2010metastatic lesions comprised mostly benign adrenal cortical adenoma (<jats:italic>n<\/jats:italic> = 10) and one non\u2010functional pheochromocytoma. Therefore, the overall false\u2010positive rate of FDG\u2010PET\/CT was 28.2 %. History of primary lung malignancy [odds ratio (OR) (95 % CI) 20.00 (1.01\u2013333.3), <jats:italic>p<\/jats:italic> = 0.049] and SUVmax &gt; 2.65 [OR (95 % CI) 31.606 (2.46\u2013405.71), <jats:italic>p<\/jats:italic> = 0.008] were independent risk factors for adrenal metastasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Single adrenal uptake on FDG\u2010PET\/CT in suspected solitary adrenal metastasis was associated with a high false\u2010positive rate (28.2 %). Risk factors associated with adrenal metastasis included a history of known primary lung malignancy and a SUVmax &gt; 2.65 at the adrenal lesion of interest on FDG\u2010PET\/CT. Based on these findings, a new algorithm was constructed.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-015-3035-3","type":"journal-article","created":{"date-parts":[[2015,3,25]],"date-time":"2015-03-25T15:13:25Z","timestamp":1427296405000},"page":"1902-1908","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["High False Positivity in Positron Emission Tomography is a Potential Diagnostic Pitfall in Patients with Suspected Adrenal Metastasis"],"prefix":"10.1002","volume":"39","author":[{"given":"Brian Hung\u2010Hin","family":"Lang","sequence":"first","affiliation":[{"name":"Department of Surgery The University of Hong Kong Hong Kong SAR China"},{"name":"Department of Surgery Queen Mary Hospital 102 Pokfulam Road Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin J.","family":"Cowling","sequence":"additional","affiliation":[{"name":"School of Public Health The University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason Yu\u2010Yin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai Pun","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koon Yat","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology The University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,3,26]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"crossref","unstructured":"KandathilA WongKK WaleDJ ZatelliMC MaffioneAM GrossMD RubelloDMetabolic and anatomic characteristics of benign and 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