TY - JOUR AU - Hahner, Stefanie AU - Hartrampf, Philipp AU - Beuschlein, Felix AU - Miederer, Matthias AU - Miehle, Konstanze AU - Schlötelburg, Wiebke AU - Fuß, Carmina Teresa AU - Pfluger, Thomas AU - Fottner, Christian AU - Tönjes, Anke AU - Herrmann, Ken AU - Amthauer, Holger AU - Reincke, Martin AU - Schreckenberger, Mathias AU - Sabri, Osama AU - Werner, Johanna AU - Reuter, Miriam AU - Kircher, Stefan AU - Arlt, Wiebke AU - Fassnacht, Martin AU - Konrad Buck, Andreas AU - Müller, Hans-Helge AU - Schirbel, Andreas TI - Combined [18F]Fluorodeoxyglucose PET and [123I]Iodometomidate-SPECT for diagnostic evaluation of indeterminate adrenal neoplasias-the cross-sectional diagnostic test accuracy study FAMIAN. JO - EBioMedicine VL - 116 SN - 2352-3964 CY - Amsterdam [u.a.] PB - Elsevier M1 - DKFZ-2025-01051 SP - 105735 PY - 2025 AB - Adrenal tumours are frequently detected by conventional imaging. However, computed tomography and magnet resonance imaging have limited specificity in classifying the most prevalent tumour type, adrenocortical adenoma (ACA), which typically does not require surgery. We proposed that combined molecular imaging with [18F]Fluorodeoxyglucose-positron emission tomography (FDG PET) and [123I]Iodometomidate-single photon emission tomography (IMTO SPECT) improves non-invasive classification of ACA.This cross-sectional, multicentre diagnostic study included patients (≥30 years) with non-functioning indeterminate adrenal masses (>3 cm or increase >1 cm, Hounsfield units [HU] ≥10 on unenhanced computed tomography [CT]) scheduled for surgery. Using histopathology as the reference, we assessed the accuracy of FDG/IMTO imaging as an ACA-test, assuming that low FDG with high IMTO uptake is indicative of ACA, with a focus on high specificity and moderate to high sensitivity. We also investigated its accuracy in detecting or excluding adrenocortical carcinoma (ACC) and evaluated FDG and unenhanced CT in assessing malignancy.EudraCT 2012-003604-13; ClinicalTrials.gov-identifier NCT02010957.From July 2015 to December 2020, 85 patients were enrolled, with 77 included in the final analysis (53 benign, 30 ACA, 9 ACC). FDG/IMTO-imaging classified ACA with high specificity (95·7 KW - Adrenal incidentaloma (Other) KW - Adrenocortical adenoma (Other) KW - Adrenocortical carcinoma (Other) KW - Computed tomography (Other) KW - Fluorodeoxyglucose positron emission tomography (Other) KW - Indeterminate adrenal masses (Other) KW - Iodometomidate SPECT (Other) KW - Molecular imaging (Other) LB - PUB:(DE-HGF)16 C6 - pmid:40398350 DO - DOI:10.1016/j.ebiom.2025.105735 UR - https://inrepo02.dkfz.de/record/301514 ER -