Adrenal Imaging

The small paired adrenal glands are essential endocrine organs superior to the kidneys. The adrenaline and noradrenaline secreted by the adrenal glands regulate the metabolism, heart rate, blood pressure, and stress response. Though most of the incidental adrenal pathologies on imaging are benign, such as an adenoma, a few adrenal lesions, such as adrenal metastases, are crucial in patient management. Adrenal adenomas represent a majority of the adrenal nodules; however, characterization on imaging is vital to avoid unnecessary intervention and hence has specific imaging protocol and flowchart to characterize them by density/signal intensity measurements on cross-sectional imaging. In this chapter, we aim to describe the imaging modalities and protocols used in characterizing adrenal lesions, the various adrenal pathologies, their imaging appearances, and their management.