Structured Evaluation of adRENal Tumors Discovered Incidentally - Prospectively Investigating the Testing Yield

NCT ID: NCT02324647

Last Updated: 2026-01-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Total Enrollment

807 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-01-31

Study Completion Date

2023-06-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Standard diagnostic work-up for adrenal incidentalomas (AI) consists of periodical biochemical analysis and CT-scanning in case the initial work-up does not demonstrate the presence of hormonal hypersecretion or adrenocortical carcinoma (ACC), respectively. The overall aim of this study is to improve the cost-effectiveness of the diagnostic strategy for AI. Cost-effectiveness of urine steroid profiling (USP) will be compared to the standard diagnostic strategy of repeated CT-imaging.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Rationale: Standard diagnostic work-up for adrenal incidentalomas (AI) consists of periodical biochemical analysis and CT-scanning in case the initial work-up does not demonstrate the presence of hormonal hypersecretion or adrenocortical carcinoma (ACC),respectively. With respect to the diagnosis of ACC, the health benefits of this strategy are controversial for the following reasons: a. critical appraisal of literature has revealed a much lower ACC frequency of 1.9% than previously presumed; b. CT sensitivity and specificity are suboptimal; c. risk of unnecessary adrenalectomies; d. exposure to ionising radiation; e. risk of CT contrast reactions (nephropathy, allergic reaction); f. health care related and economical costs. The hypothesis to be tested is that incorporation of a single baseline urinary steroid profiling (USP) into the management algorithm of AI is more cost-effective than a strategy solely based on repeat CT-scanning.

Objective: SERENDIPITY aims to improve the cost-effectiveness of the diagnostic strategy for AI by the application of a single baseline USP. In addition, we aim to examine the psychological impact for patients with AI being currently subjected to repeated laboratory tests and CT-scanning during several years.

Study design: This is a prospective observational multicenter study. Study population: Patients are eligible if they meet the following inclusion criteria: adrenal mass \> 1 cm in diameter incidentally discovered during CT or MRI-scanning, performed for reasons other than an evaluation for adrenal disease and age 18 years or older. The exclusion criteria are: extra-adrenal malignancy (i.e. active or past medical history of malignancy, except for basal cell carcinoma), radiologic diagnosis of simple cyst or bilateral adrenal masses, allergy to radiocontrast, renal insufficiency (i.e. eGFR \< 30 ml/min/1.73m2), pregnancy or inability to understand written Dutch.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Adrenal Incidentaloma Adrenocortical Carcinoma

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* discrete adrenal mass \> 1 cm in diameter incidentally discovered during CT/MRI-scanning, performed for reasons other than an evaluation for adrenal disease
* detection CT/MRI-scan performed ≤ 4 months ago
* age 18 years or older.

Exclusion Criteria

* extra-adrenal malignancy (i.e. active or past medical history of malignancy, except for basal cell carcinoma)
* radiologic diagnosis of simple cyst or bilateral adrenal masses
* allergy to radiocontrast
* renal insufficiency (i.e. eGFR \< 30 ml/min/1.73m2)
* pregnancy
* adrenal incidentaloma visible on previous (i.e. \> 4 months ago) CT/MRI-scan
* inability to understand written Dutch.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

OTHER

Sponsor Role collaborator

Amsterdam UMC, location VUmc

OTHER

Sponsor Role collaborator

Radboud University Medical Center

OTHER

Sponsor Role collaborator

Leiden University Medical Center

OTHER

Sponsor Role collaborator

Maastricht University Medical Center

OTHER

Sponsor Role collaborator

UMC Utrecht

OTHER

Sponsor Role collaborator

Erasmus Medical Center

OTHER

Sponsor Role collaborator

Martini Hospital Groningen

OTHER

Sponsor Role collaborator

Canisius-Wilhelmina Hospital

OTHER

Sponsor Role collaborator

Diakonessenhuis, Utrecht

OTHER

Sponsor Role collaborator

Isala

OTHER

Sponsor Role collaborator

Haga Hospital

OTHER

Sponsor Role collaborator

St. Antonius Hospital

OTHER

Sponsor Role collaborator

Kennemer Gasthuis

OTHER

Sponsor Role collaborator

Maxima Medical Center

OTHER

Sponsor Role collaborator

Medical Center Alkmaar

OTHER

Sponsor Role collaborator

Frisius Medisch Centrum

OTHER

Sponsor Role collaborator

Meander Medical Center

OTHER

Sponsor Role collaborator

Medisch Spectrum Twente

OTHER

Sponsor Role collaborator

Onze Lieve Vrouwe Gasthuis

OTHER

Sponsor Role collaborator

Rijnstate Hospital

OTHER

Sponsor Role collaborator

Elisabeth-TweeSteden Ziekenhuis

OTHER

Sponsor Role collaborator

Tergooi Hospital

OTHER

Sponsor Role collaborator

Vlietland Ziekenhuis

OTHER

Sponsor Role collaborator

Treant ziekenhuis

UNKNOWN

Sponsor Role collaborator

Flevoziekenhuis

OTHER

Sponsor Role collaborator

University Medical Center Groningen

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Michiel N Kerstens, MD, PhD

Role: STUDY_DIRECTOR

University Medical Center Groningen

E Buitenwerf, MD

Role: PRINCIPAL_INVESTIGATOR

University Medical Center Groningen

P.H.L.T. Bisschop, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Amsterdam UMC, location VUmc

E.M.W. Eekhoff, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Free University UMC Amsterdam

E.P.M. van der Kleij-Corssmit, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Leiden University Medical Center

R.A. Feelders, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Erasmus Medical Center

B. Havekes, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Maastricht University Medical Center

H.J.L.M Timmers, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

UMC St Radboud Nijmegen

G.D. Valk, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

UMC Utrecht

P.H.N. Oomen, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

medical center leeuwarden

K.M. van Tol, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Martini Hospital Groningen

R.S.M.E. Wouters, MD

Role: PRINCIPAL_INVESTIGATOR

Scheper Hospital

A.A.M. Franken, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Isala

J.R. Meinardi, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Canisius-Wilhelmina Hospital

R. GrooteVeldman, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Medisch Spectrum Twente

P.C. Oldenburg-Ligtenberg, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Meander Medical Center

A.F. Muller, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Diakonessenhuis, Utrecht

M.O. van Aken, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Haga Hospital

W. de Ronde, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Kennemer Gasthuis

H.R. Haak, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Maxima Medical Center

S. Simsek, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Medical Center Alkmaar

I.M.M.J. Wakelkamp, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

St. Antonius Hospital

I.I.L. Berk-Planken, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Vlietland Ziekenhuis

P.S. van Dam, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Onze Lieve Vrouwe Gasthuis

H. de Boer, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Rijnstate Hospital

J.J.J. de Sonnaville, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Tergooi Hospital

E. Donga, MD

Role: PRINCIPAL_INVESTIGATOR

St.Elisabeth Hospital

N. Smit, MD

Role: PRINCIPAL_INVESTIGATOR

Flevoland Hospital

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University Medical Center Groningen

Groningen, Provincie Groningen, Netherlands

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Netherlands

References

Explore related publications, articles, or registry entries linked to this study.

Kievit J, Haak HR. Diagnosis and treatment of adrenal incidentaloma. A cost-effectiveness analysis. Endocrinol Metab Clin North Am. 2000 Mar;29(1):69-90, viii-ix. doi: 10.1016/s0889-8529(05)70117-1.

Reference Type BACKGROUND
PMID: 10732265 (View on PubMed)

Nawar R, Aron D. Adrenal incidentalomas -- a continuing management dilemma. Endocr Relat Cancer. 2005 Sep;12(3):585-98. doi: 10.1677/erc.1.00951.

Reference Type BACKGROUND
PMID: 16172193 (View on PubMed)

Grumbach MM, Biller BM, Braunstein GD, Campbell KK, Carney JA, Godley PA, Harris EL, Lee JK, Oertel YC, Posner MC, Schlechte JA, Wieand HS. Management of the clinically inapparent adrenal mass ("incidentaloma"). Ann Intern Med. 2003 Mar 4;138(5):424-9. doi: 10.7326/0003-4819-138-5-200303040-00013.

Reference Type BACKGROUND
PMID: 12614096 (View on PubMed)

Young WF Jr. Clinical practice. The incidentally discovered adrenal mass. N Engl J Med. 2007 Feb 8;356(6):601-10. doi: 10.1056/NEJMcp065470. No abstract available.

Reference Type BACKGROUND
PMID: 17287480 (View on PubMed)

Cawood TJ, Hunt PJ, O'Shea D, Cole D, Soule S. Recommended evaluation of adrenal incidentalomas is costly, has high false-positive rates and confers a risk of fatal cancer that is similar to the risk of the adrenal lesion becoming malignant; time for a rethink? Eur J Endocrinol. 2009 Oct;161(4):513-27. doi: 10.1530/EJE-09-0234. Epub 2009 May 13.

Reference Type BACKGROUND
PMID: 19439510 (View on PubMed)

Johnson PT, Horton KM, Fishman EK. Adrenal mass imaging with multidetector CT: pathologic conditions, pearls, and pitfalls. Radiographics. 2009 Sep-Oct;29(5):1333-51. doi: 10.1148/rg.295095027.

Reference Type BACKGROUND
PMID: 19755599 (View on PubMed)

Wolthers BG, Kraan GP. Clinical applications of gas chromatography and gas chromatography-mass spectrometry of steroids. J Chromatogr A. 1999 May 28;843(1-2):247-74. doi: 10.1016/s0021-9673(99)00153-3.

Reference Type BACKGROUND
PMID: 10399855 (View on PubMed)

Grondal S, Eriksson B, Hagenas L, Werner S, Curstedt T. Steroid profile in urine: a useful tool in the diagnosis and follow up of adrenocortical carcinoma. Acta Endocrinol (Copenh). 1990 May;122(5):656-63. doi: 10.1530/acta.0.1220656.

Reference Type BACKGROUND
PMID: 2141212 (View on PubMed)

Khorram-Manesh A, Ahlman H, Jansson S, Wangberg B, Nilsson O, Jakobsson CE, Eliasson B, Lindstedt S, Tisell LE. Adrenocortical carcinoma: surgery and mitotane for treatment and steroid profiles for follow-up. World J Surg. 1998 Jun;22(6):605-11; discussion 611-2. doi: 10.1007/s002689900442.

Reference Type BACKGROUND
PMID: 9597936 (View on PubMed)

Kikuchi E, Yanaihara H, Nakashima J, Homma K, Ohigashi T, Asakura H, Tachibana M, Shibata H, Saruta T, Murai M. Urinary steroid profile in adrenocortical tumors. Biomed Pharmacother. 2000 Jun;54 Suppl 1:194s-197s. doi: 10.1016/s0753-3322(00)80043-8.

Reference Type BACKGROUND
PMID: 10915023 (View on PubMed)

Minowada S, Kinoshita K, Hara M, Isurugi K, Uchikawa T, Niijima T. Measurement of urinary steroid profile in patients with adrenal tumor as a screening method for carcinoma. Endocrinol Jpn. 1985 Feb;32(1):29-37. doi: 10.1507/endocrj1954.32.29.

Reference Type BACKGROUND
PMID: 4017973 (View on PubMed)

Brazier J, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. J Health Econ. 2002 Mar;21(2):271-92. doi: 10.1016/s0167-6296(01)00130-8.

Reference Type BACKGROUND
PMID: 11939242 (View on PubMed)

Arnaldi G, Boscaro M. Adrenal incidentaloma. Best Pract Res Clin Endocrinol Metab. 2012 Aug;26(4):405-19. doi: 10.1016/j.beem.2011.12.006. Epub 2012 May 22.

Reference Type BACKGROUND
PMID: 22863384 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

4799

Identifier Type: REGISTRY

Identifier Source: secondary_id

UGroningen

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Diagnosis of Pheochromocytoma
NCT00004847 RECRUITING PHASE1