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PURPOSE: Percutaneous CT guided biopsy is accepted as a safe procedure for the diagnosis of indeterminate adrenal masses in oncologic patients. The purpose of this study was to evaluate the accuracy of a ‘negative for tumour’ adrenal biopsy in the oncologic patient population by assessing subsequent outcome including clinical course, size and imaging characteristics of the adrenal lesions on follow-up imaging studies and pathological findings at re-biopsy or following adrenal mass resection. MATERIALS AND METHODS: Retrospective analysis of 225 oncological patients (FM, 128;87; age range 33–87 years, mean age 66 years) who had undergone CT guided biopsies of an adrenal mass over a 5-year period was performed. Those patients with a report consistent with ‘negative for malignancy’ were evaluated by reviewing the medical records for patient demographics, primary malignancy, histology of adrenal tumour, subsequent surgical interventions, repeat adrenal biopsy under image guidance, by open surgery or at autopsy, subsequent abdominal imaging in which the adrenal gland was imaged, and long-term outcome including hospital admissions, or death. RESULTS: Of the 225 CT-guided adrenal biopsies performed, 41 (18%) were negative for neoplasm. The primary neoplasm in these 41 patients included lung cancer (n=32), breast (n=5), renal cell carcinoma (n=2), bladder (n=1), and prostate (n=1). The size of the adrenal lesions ranged from 2.8–5cm. Of the 41 biopsies, which were negative for tumour; 10 were identified as adenomas and the rest showed benign adrenal cortical cells or hyperplasia on cytopathology and histopathology. Repeat biopsies were obtained in 13/41 (31%) patients; whereas 2/41 (5%) had their adrenal gland analyzed on post mortem examination. None of these 15 repeat evaluations yielded tumour. CONCLUSION: In oncological patients, pathological analysis of tissue samples obtained by CT-guided percutaneous biopsy, suggesting benign aetiology, is reliable and predicts a benign course on long-term follow-up. A negative or benign pathology result for a CT guided percutaneous adrenal biopsy can be regarded as a true negative evaluation in oncological patients with no necessity to repeat the biopsy. Harisinghani M. G. et al.(2002) Clinical Radiology,57,898–901.

AIM: A dose ranging multicentre phase-II clinical trial was conducted to evaluate the efficacy of ultrasmall superparamagnetic iron oxide (USPIO) ferumoxtran-10 for magnetic resonance (MR) imaging of focal hepatic lesions.

1.1. Iron tagged with the radioactive isotope Fe59was fed in single doses, ranging from 1.8 to 120 mg., to 466 women at various stages of pregnancy, and the uptake of iron determined.2.2. As the dosage was increased from 9 to 18 mg. and beyond, the percentage of the total dose of iron found in the maternal red cells decreased, while the amount of iron taken up increased from the lowest to the highest dose.3.3. As gestation progressed, the uptake of iron increased to the extent that at thirty weeks' gestation and over, three or more times as much iron was absorbed as during the period before the fifteenth week of gestation.4.4. The therapeutic implications of these findings are discussed. The inefficiency of absorption of large doses of iron for normal pregnant women is noted.5.5. The variation in uptake of the fetus with varying dosage does not appear to be greatly different from that of the mother. Relatively little variation in the amount of radioactive iron in the red cells of the infant at birth was observed for iron administered at different periods of gestation. The red blood cell mass of the newborn infant contained on the average about 10 per cent as much of the administered iron as that of the mother. The ratio of fetal to maternal radioactive iron per milliliter of red blood cells was not greatly different from one.6.6. The relation between parity and iron uptake is discussed.

1. The use of radioactive sodium provides a delicate method whereby the transportation of this substance throughout the body may be accurately followed.2. Radioactive sodium readily passes into the general circulation following its instillation into a traumatized vagina. Absorption from the intact vagina and/or cervix is less marked.3. These experiments suggest the need for special caution in administering douches containing poisonous ingredients, particulary when the vagina and/or cervix have been recently traumatized.