Publication Name	World Journal of Radiology
Manuscript ID	119833
Country	Greece

Category	Endocrinology & Metabolism
Manuscript Type	Minireviews
Article Title	Evaluation of adrenal incidentalomas: Current approaches, caveats, and unexplored issues
Manuscript Source	Invited Manuscript
All Author List	Eleni Kouroglou, Vasiliki Tsiama, Evaggelia Stroumpouli, Christos Savvidis, Efthymia Kallistrou, Dimitra Ragia, Dimitra Motsiou, Stella Proikaki, Konstantinos Belis and Ioannis Ilias
Funding Agency and Grant Number
Corresponding Author	Ioannis Ilias, Director, MD, PhD, Department of Endocrinology, Hippocration General Hospital, No. 63 Evrou Street, Athens GR-11527, Greece. iiliasmd@yahoo.com
Key Words	Adrenal incidentaloma; Mild autonomous cortisol secretion; Non-contrast computed tomography attenuation; Adrenal washout computed tomography; Adrenal venous sampling; Cardiometabolic risk
Core Tip	Incidental adrenal masses are increasingly identified through modern imaging, and physicians must differentiate benign from malignant lesions while excluding hormonal hypersecretion. Mild autonomous cortisol secretion is common and carries cardiometabolic/skeletal risks, warranting biochemical evaluation. Current evidence supports a conservative radiologic approach: Homogeneous adrenal lesions with non-contrast computed tomography attenuation ≤ 10 Hounsfield units are considered benign, and emerging data suggest this threshold may safely extend to ≤ 20 Hounsfield units. The utility of adrenal washout computed tomography is increasingly questioned due to its poor discrimination of pheochromocytoma and limited cost-effectiveness. Future research should address psychiatric consequences and novel etiological factors.
Citation	Kouroglou E, Tsiama V, Stroumpouli E, Savvidis C, Kallistrou E, Ragia D, Motsiou D, Proikaki S, Belis K, Ilias I. Evaluation of adrenal incidentalomas: Current approaches, caveats, and unexplored issues. World J Radiol 2026; In press

Received	2026-02-07 03:00
Peer-Review Started	2026-02-07 03:00
First Decision by Editorial Office Director	2026-02-28 06:56
Return for Revision	2026-02-28 06:56
Revised	2026-03-03 13:33
Publication Fee Transferred
Second Decision by Editor	2026-04-07 02:44
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-04-08 01:38
Articles in Press	2026-04-08 01:38
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1949-8470 (online)
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