FIG. 3.
Systematic algorithm to determine adrenal status in patients with non-small cell lung cancer (NSCLC) based on positron emission tomography/computed tomography (PET/CT) Hounsfield unit (HU) mean attenuation, standard uptake value (SUV)max, and SUVratio thresholds. Other imaging modalities such as washout CT and chemical shift magnetic resonance imaging (MRI) are not a part of the National Comprehensive Care Network guideline staging recommendations but are common clinical radiology practice. All patients should have an endocrine functional work-up of the mass in addition to imaging. Supportive literature is found within the text. ASII=Adrenal Signal Intensity Index; ASR=Adrenal-Spleen Chemical Shift Ratio.