[¹²³I]Iodometomidate imaging in adrenocortical carcinoma
Open accessAbstract
CONTEXT: Imaging with [¹²³I]iodometomidate ([¹²³I]IMTO) has been shown to diagnose adrenocortical lesions with high sensitivity and specificity. OBJECTIVE: Our objective was to evaluate the clinical utility of [¹²³I]IMTO imaging in adrenocortical carcinoma (ACC). DESIGN: We conducted a prospective monocentric diagnostic study and a prospective case series at a single tertiary referral center. PATIENTS AND INTERVENTIONS: Fifty-eight patients with histologically confirmed ACC, all European Network for the Study of Adrenal Tumors stage IV (with distant metastases), received 185 MBq [¹²³I]IMTO. Sequential planar whole-body scans until 24 hours post injection and single photon emission computed tomography/computed tomography (SPECT/CT) hybrid imaging 4 to 6 hours post injection were performed. MAIN OUTCOME MEASURES: Outcome measures included uptake of [¹²³I]IMTO in ACC lesions, sensitivity and specificity of [¹²³I]IMTO imaging compared with conventional imaging, and number of patients eligible for [¹³¹I]IMTO therapy. RESULTS: Of 430 lesions detected by conventional imaging, 30% showed strong, 8% moderate, and 62% no tracer accumulation. [¹²³I]IMTO detected both primary and metastatic lesions of ACC. However, a substantial percentage of lesions failed to show [¹²³I]IMTO uptake. The overall sensitivity and specificity values were 38% and 100%, respectively. Thirty-four patients (59%) had at least 1 [¹²³I]IMTO-positive lesion. Cortisol and aldosterone secretion by ACC was positively correlated to [¹²³I]IMTO uptake (P = .01); cytotoxic chemotherapy and mitotane treatment presumably did not influence tracer uptake. Twenty-one patients (36.2%) had radiotracer uptake in all lesions ≥ 2 cm and therefore were potential candidates for targeted systemic radiotherapy with [¹³¹I]IMTO. CONCLUSION: About one-third of patients with ACC show specific retention of [¹²³I]IMTO in metastatic lesions. This study provides support for the conduct of a prospective trial to determine whether the first molecular informed therapy using [¹³¹I]IMTO will be of value to patients with metastatic ACC.
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123I-IMTO has reported value for staging of ACC.
“123I-IMTO SPECT-CT permits highly specific characterization of adrenocortical tissue with lower radiation exposure and investigation than NP-59 scintigraphy (368) and also has reported value for the staging of ACC (369).”
From Adrenal incidentaloma (2020) · cites this paper as [369]
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- Authors
- Kreissl, M. C., Schirbel, A., Fassnacht, M., Haenscheid, H., Verburg, F. A., Bock, S., Saeger, W., Knoedler, P., Reiners, C., Buck, A. K., Allolio, B., & Hahner, S.
- Affiliations
- Departments of Nuclear Medicine (M.C.K., A.S., H.H., F.A.V., C.R., A.K.B.), D-97080 Wuerzburg, Germany;
- University of Würzburg (DE)
- Universitätsklinikum Aachen (DE)
- Marienkrankenhaus Hamburg (DE)
- Radiology (P.K.), D-97080 Wuerzburg, Germany;
- Corresponding author
- Kreissl, Michael C.
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2013-07-01
- Volume
- 98
- Issue
- 7
- Pages
- 2755-2764
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2094333335
- Cited by
- 50
- References
- 35
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 1 · 2022: 4 · 2021: 7 · 2020: 5 · 2019: 3 · 2018: 2 · 2017: 1 · 2016: 5 · 2015: 9 · 2014: 6 · 2013: 2
- FWCI
- 7.22
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RWTH Publications (RWTH Aachen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Keywords
- adrenocortical carcinoma, SPECT/CT imaging, metastatic adrenal cancer, molecular imaging, radioiodine therapy, cortisol secretion, aldosterone secretion, sensitivity and specificity, mitotane
- MeSH terms
- Adrenal Cortex, Adrenal Cortex Neoplasms, Adult, Aged, Aldosterone, Etomidate, Female, Humans, Hydrocortisone, Iodine Radioisotopes, Male, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Pilot Projects, Prospective Studies, Sensitivity and Specificity, Tomography, X-Ray Computed, Cohort Studies, Tomography, Emission-Computed, Single-Photon, Adrenocortical Carcinoma, Radiopharmaceuticals, Whole Body Imaging
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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