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Cited by 66Adrenal and Paraganglionic TumorsAdvanced MRI Techniques and ApplicationsMedical Imaging Techniques and Applications

Chemical shift imaging for evaluation of adrenal masses: a systematic review and meta-analysis

Platzek, Ivan, Sieron, Dominik, Plodeck, Verena, Borkowetz, Angelika, Laniado, Michael, Hoffmann, Ralf-Thorsten·2019·European Radiology
DOI 10.1007/s00330-018-5626-5
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Abstract

Objectives To perform a systematic review and meta-analysis of published data to evaluate the utility of chemical shift imaging (CSI) for differentiating between adrenal adenomas and non-adenomas.Methods A systematic search of the MEDLINE, Web of Science Core Collection, EMBASE and Cochrane Central Register of Controlled Trials electronic databases was performed. The methodological quality of the included studies was assessed by using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tool. A bivariate random effect model was used to determine summary and subgroup sensitivity and specificity and calculate summary receiver operating characteristic curves (SROC).Results Eighteen studies with 1138 patients and 1280 lesions (859 adenomas, 421 non-adenomas) in total were included. In addition to summary analysis, quantitative analyses of the adrenal signal intensity index (SII, 978 lesions, 14 studies), adrenal-to-spleen ratio (ASR; 394 lesions, 7 studies) and visual analysis (560 lesions, 5 studies) were performed. The resultant data showed considerable heterogeneity (inconsistency index I 2 of 94%, based on the diagnostic odds ratio, DOR). The pooled sensitivity of CSI for adenoma was 0.94 [95% confidence interval (CI) 0.88-0.97] and pooled specificity was 0.95 (95% CI 0.89-0.97). The area (AUC) under the SROC curve was 0.98 (95% CI 0.96-0.99). The corresponding AUCs were 0.98, 0.99 and 0.95 for SII, ASR and visual evaluation, respectively.Conclusion CSI has high sensitivity, specificity and accuracy for adrenal adenoma. Diagnostic performance does not improve when quantitative indices are used.Key points • Inclusion of CSI in abdominal MRI protocols provides an effective solution for classifying adrenal masses discovered on MR exams • Visual evaluation of adrenal CSI is sufficient; use of quantitative indices does not improve diagnostic accuracy.

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Crossref · 10.1007/s00330-018-5626-5

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  • Chemical shift MRI to detect intracellular fat within lipid-rich adrenal adenomas was first described in 1992.

    “The use of chemical shift MRI to detect intracellular fat within lipid-rich adrenal adenomas and differentiate these from other lesions was first described in 1992 (310) (Fig. 7).”

    From Adrenal incidentaloma (2020) · cites this paper as [310]

  • Visual and quantitative analysis of adrenal signal intensity index and adrenal-to-spleen ratio have high accuracy (95-98%) for lipid-rich adenoma detection; diagnostic performance not significantly improved by these indices.

    “A recent systematic review and meta-analysis reported that visual analysis and quantitative analysis of adrenal signal intensity index and adrenal-to-spleen ratio all have high accuracy for lipid-rich adenoma detection (95-98%), and diagnostic performance is not significantly improved by adrenal signal intensity index or the adrenal-to-spleen ratio (310).”

    From Adrenal incidentaloma (2020) · cites this paper as [310]

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Authors
Platzek, I., Sieron, D., Plodeck, V., Borkowetz, A., Laniado, M., & Hoffmann, R.-T.
Affiliations
University Hospital Carl Gustav Carus (DE)
Corresponding author
Platzek, Ivan
ORCID
Venue
European Radiology
Publisher
Springer Science and Business Media LLC
Published
2018-07-16
Volume
29
Issue
2
Pages
806-817
ISSN
  • 0938-7994 (ISSN-L)
  • 1432-1084
DOI
10.1007/s00330-018-5626-5
OpenAlex
W2884548994
Cited by
66
References
48
Citations by year
2026: 8 · 2025: 12 · 2024: 8 · 2023: 7 · 2022: 14 · 2021: 8 · 2020: 5 · 2019: 1 · 2018: 2
FWCI
0.89
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • European Radiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
Keywords
magnetic resonance spectroscopic imaging, adrenal mass, adrenal adenoma, diagnostic accuracy, abdominal MRI
MeSH terms
Adrenal Cortex Neoplasms, Adrenal Gland Diseases, Diagnosis, Differential, Humans, Magnetic Resonance Imaging, ROC Curve, Sensitivity and Specificity, Adrenocortical Adenoma, Area Under Curve

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