Managing diagnosis and treatment paths. The case for adrenal tumour imaging

The recent and wide innovation in diagnostic imaging has provided the availability of multiple and different techniques to evaluate patients with hypersecreting or non-hypersecreting adrenal tumours, such as anatomic modalities, mainly represented by computed tomography (CT) and magnetic resonance (MR), or functional studies consisting of radionuclide molecular scans. Furthermore, advanced hybrid imaging, currently represented by combined positron emission tomography (PET) and CT (PET-CT), is attractive and reflects the diagnostic significance of morpho-functional integrated imaging which simultaneously offers information regarding the anatomic characteristics and metabolic features of adrenal tumours. Since the fundamental clinical issue in such patients is tumour characterization for correct treatment planning, it is crucial to establish the correct selection of imaging techniques as well as imaging protocols according to patient clinical scenario, patient safety and cost-effectiveness performance of selected diagnostic approach; therefore, the appropriate management of such imaging modalities is clinically recommended.