ArticleInternal medicine journal2026
Outcomes and opportunities: evaluating an unselected cohort of patients with adrenal incidentaloma at a tertiary hospital in New Zealand.
Article in Internal medicine journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe prevalence of adrenal incidentalomas is increasing, along with the incidence of functional or malignant lesions. This study assessed how imaging of adrenal incidentalomas at a tertiary hospital in Auckland, New Zealand, without a dedicated adrenal incidentaloma service, conformed to the American College of Radiology (ACR) recommendations for radiological screening, as well as how using a non-washout imaging approach affected clinical and service outcomes. Secondary outcomes included determining how biochemical screening conformed to the European Society of Endocrinology (ESE) guidelines and patient-related factors influencing completion of ACR screening.
methodsA retrospective audit of adrenal incidentalomas was performed using a local healthcare database
resultsData from 10 278 consecutive patients with computed tomography scans were evaluated. The overall prevalence of incidentalomas was 1.4%, and 143 lesions were detected. Of these, 65/143 (45.5%) followed the ACR imaging guidelines, and 21/143 (14.7%) followed the ESE guidelines. Older adults were 2.9 times less likely to complete ACR and ESE follow-up compared to younger adults, while people with lesions >4 cm versus ≤4 cm were more likely to complete ACR follow-up. Only 11 patients were referred to endocrinology, and this subgroup had a significantly higher rate of ACR adherent evaluation (81.8% vs 12.1%, P = 0.0002). Using a non-washout method of radiological follow-up resulted in 80 fewer scans.
conclusionMost patients with adrenal incidentalomas did not receive guideline-recommended imaging or biochemical follow-up. The establishment of integrated adrenal incidentaloma clinics and the use of non-washout follow-up scans may improve both clinical outcomes and patient experience.
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