Adherence to Clinical Guidelines in the Radiographic and Biochemical Evaluation of Adrenal Incidentalomas Detected on Diagnostic Imaging: An Open Access Observational Analysis

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Main Author:	Camilo Fernández w, MD/ PhD/ FACC
Format:	Recurso digital
Published:	Zenodo 2026
Online Access:	Acceder al recurso
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author	Camilo Fernández w, MD/ PhD/ FACC
author_facet	Camilo Fernández w, MD/ PhD/ FACC
contents	<p> </p> <p>Abstract</p> <p> </p> <p> </p> <p>Background: Adrenal incidentalomas (AIs) are adrenal masses discovered incidentally on imaging studies performed for unrelated indications. Clinical guidelines recommend a standardized radiographic and biochemical evaluation to distinguish benign from malignant lesions and identify hormonally active tumors.</p> <p> </p> <p>Objective: To evaluate adherence to guideline-recommended radiographic and biochemical workup in patients with adrenal incidentalomas detected on diagnostic imaging and assess factors influencing compliance.</p> <p> </p> <p>Methods: We conducted a multicenter, observational study of 312 adult patients with adrenal incidentalomas identified between 2020 and 2025. Adherence to international guidelines, including imaging characterization (CT/MRI), biochemical evaluation (cortisol, catecholamines, aldosterone), and follow-up protocols, was analyzed. Demographic, clinical, and institutional factors influencing adherence were assessed.</p> <p> </p> <p>Results: Complete adherence to radiographic and biochemical recommendations was observed in 62% of cases. Imaging characterization using non-contrast CT or MRI was performed in 94% of patients, while complete biochemical screening was documented in 70%. Factors associated with higher adherence included tertiary care centers, endocrinology consultation, and multidisciplinary team involvement. Non-adherence was frequently due to lack of standardized protocols or incomplete follow-up.</p> <p> </p> <p>Conclusions: Despite established guidelines, significant gaps exist in the evaluation of adrenal incidentalomas. Implementation of structured, clinic-based protocols and multidisciplinary management improves adherence, potentially optimizing early detection of malignancy and hormonally active tumors.</p> <p> </p> <p>Keywords: Adrenal incidentaloma, guideline adherence, biochemical evaluation, radiographic workup, CT, MRI, endocrinology</p>
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publishDate	2026
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spellingShingle	Adherence to Clinical Guidelines in the Radiographic and Biochemical Evaluation of Adrenal Incidentalomas Detected on Diagnostic Imaging: An Open Access Observational Analysis Camilo Fernández w, MD/ PhD/ FACC <p> </p> <p>Abstract</p> <p> </p> <p> </p> <p>Background: Adrenal incidentalomas (AIs) are adrenal masses discovered incidentally on imaging studies performed for unrelated indications. Clinical guidelines recommend a standardized radiographic and biochemical evaluation to distinguish benign from malignant lesions and identify hormonally active tumors.</p> <p> </p> <p>Objective: To evaluate adherence to guideline-recommended radiographic and biochemical workup in patients with adrenal incidentalomas detected on diagnostic imaging and assess factors influencing compliance.</p> <p> </p> <p>Methods: We conducted a multicenter, observational study of 312 adult patients with adrenal incidentalomas identified between 2020 and 2025. Adherence to international guidelines, including imaging characterization (CT/MRI), biochemical evaluation (cortisol, catecholamines, aldosterone), and follow-up protocols, was analyzed. Demographic, clinical, and institutional factors influencing adherence were assessed.</p> <p> </p> <p>Results: Complete adherence to radiographic and biochemical recommendations was observed in 62% of cases. Imaging characterization using non-contrast CT or MRI was performed in 94% of patients, while complete biochemical screening was documented in 70%. Factors associated with higher adherence included tertiary care centers, endocrinology consultation, and multidisciplinary team involvement. Non-adherence was frequently due to lack of standardized protocols or incomplete follow-up.</p> <p> </p> <p>Conclusions: Despite established guidelines, significant gaps exist in the evaluation of adrenal incidentalomas. Implementation of structured, clinic-based protocols and multidisciplinary management improves adherence, potentially optimizing early detection of malignancy and hormonally active tumors.</p> <p> </p> <p>Keywords: Adrenal incidentaloma, guideline adherence, biochemical evaluation, radiographic workup, CT, MRI, endocrinology</p>
title	Adherence to Clinical Guidelines in the Radiographic and Biochemical Evaluation of Adrenal Incidentalomas Detected on Diagnostic Imaging: An Open Access Observational Analysis
url	https://doi.org/10.5281/zenodo.18631727

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