许多肾上腺肿瘤被认为放射学不确定并通过手术切除。肾上腺组织与甲状旁腺一样，具有近红外自发荧光 (NIRAF) 特性。本研究旨在探讨 NIRAF 区分良性和恶性肾上腺肿瘤的潜力。对 2021 年 10 月至 2023 年 5 月期间接受肾上腺切除术的患者进行了前瞻性研究。使用 NIRAF 成像检查肾上腺切除标本。记录样本自发荧光（AF）特征。对不同肿瘤类型进行比较，并构建逻辑回归模型来区分良性肿瘤和恶性肿瘤。使用受试者工作特征曲线来确定区分良性肿瘤和恶性肿瘤的最佳 AF 阈值。总共检查了 108 份肾上腺标本：肾上腺皮质腺瘤/其他良性病变 (n = 72)、嗜铬细胞瘤 (n = 18)、肾上腺皮质肿瘤不确定的行为（n = 4）和恶性肿瘤（n = 14）。当将肾上腺皮质腺瘤（背景的 3.08 倍）与嗜铬细胞瘤（1.95，p = 0.001）和恶性肿瘤（1.11，p < 0.0001）进行比较时，发现标准化 AF 强度存在显着差异。区分良性肿瘤和恶性肿瘤的曲线下面积为 0.87，最佳标准化 AF 阈值为 1.93。不同的肾上腺病理表现出不同的 AF 特性。这些发现表明 NIRAF 在预测放射学不确定的肾上腺肿瘤的良性与恶性性质方面具有潜在的术中效用。© 2024。作者。

Many adrenal tumors are deemed radiologically indeterminate and surgically removed. Adrenal tissue, like parathyroid glands, exhibits near-infrared autofluorescence (NIRAF) properties. This study was designed to investigate the potential of NIRAF to differentiate benign versus malignant adrenal tumors.Patients undergoing adrenalectomy between October 2021 and May 2023 were prospectively studied. Adrenalectomy specimens were inspected with NIRAF imaging. Specimen autofluorescence (AF) characteristics were recorded. Comparisons were made between different tumor types and a logistic regression model was constructed to differentiate benign versus malignant tumors. A receiver operating characteristic curve was used to identify an optimal AF threshold differentiating benign versus malignant tumors.A total of 108 adrenal specimens were examined: adrenocortical adenomas/other benign lesions (n = 72), pheochromocytomas (n = 18), adrenocortical neoplasms of uncertain behavior (n = 4), and malignant tumors (n = 14). A significant difference in normalized AF intensity was identified when comparing adrenocortical adenomas (3.08 times background) with pheochromocytomas (1.95, p = 0.001) and malignant tumors (1.11, p < 0.0001). The Area Under the Curve differentiating benign vs malignant tumors was 0.87, with an optimal normalized AF threshold at 1.93.Different adrenal pathologies exhibit diverse AF properties. These findings suggest a potential intraoperative utility of NIRAF in predicting benign versus malignant nature for radiologically indeterminate adrenal tumors.© 2024. The Author(s).