Imaging of Adrenal Incidentalomas and Their Mimics: A Practical Update for Risk Stratification and Management from a Precision Imaging Perspective

Background/Objectives: To provide an updated overview of adrenal incidentaloma evaluation, characterize the principal imaging mimics across pediatric and adult populations, and propose a clinically actionable approach integrating endocrine assessment with conventional and advanced imaging.

Methods

A narrative review of recent evidence and major international recommendations was performed, focusing on epidemiology, endocrine work-up, non-contrast computed tomography (CT), washout CT, magnetic resonance imaging (MRI), and dual-energy CT (DECT).