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Cited by 18Adrenal and Paraganglionic TumorsMedical Imaging Techniques and ApplicationsRenal cell carcinoma treatment

Characterization of adrenal lesions using MDCT wash-out parameters: diagnostic accuracy of several combinations of intermediate and delayed phases

Foti, Giovanni, Malleo, Giuseppe, Faccioli, Niccolò, Guerriero, Andrea, Furlani, Lino, Carbognin, Giovanni·2018·La radiologia medica
DOI 10.1007/s11547-018-0911-6
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Abstract

Purpose To evaluate the diagnostic accuracy of wash-out parameters calculated using multiple intermediate and delayed phases.Materials and methods This prospective study had institutional review board approval and informed consent was obtained from all patients. Between January 2012 and October 2016, 108 consecutive oncologic patients (59 males, 49 females, mean age 52.6 years; 129 diagnosed lesions) underwent multiphasic CT protocol including unenhanced (UE), arterial (AE), portal (PE), 5-min (DE-5) and the 15-min (DE-15) delayed phases of adrenal glands. All images were randomly reviewed in consensus by two radiologists experienced in abdominal CT, unaware of clinical or pathologic data. Location, size and density were recorded. Absolute wash-out, percentage wash-out (PWO) and percentage enhancement wash-out ratio were calculated. The thresholds yielding the best accuracy in differentiating adenomas from nonadenomas were retrospectively determined on the basis of ROC curves. The corresponding diagnostic accuracy values were calculated. Paired sample t test was used to assess differences among imaging parameters within subgroups. Student t test was applied to compare lesions between independent subgroups. p values ≤ 0.05 were considered significant.Results The final diagnosis included 82 adenomas (62 lipid-rich and 20 lipid-poor) and 47 nonadenomas (42 metastases, 3 pheochromocytomas, 2 carcinomas). All the 62 lipid-rich adenomas were correctly diagnosed as benign lesions on the basis of their UE attenuation < 10 HU. The PEAK attenuation was achieved during AE phase for 51/129 lesions (39.5%) and at the time of PE phase in 78/129 lesions (60.5%). The best overall accuracy in diagnosing adenomas (97.6%; 126/129 lesions correctly diagnosed) was obtained using 40% threshold for calculating PWO from PEAK to DE-15 scan.Conclusions If only an intermediate phase is available, the 15-min delayed scan should be acquired to avoid any drop in diagnostic accuracy. The availability of two intermediate phase may be used to easy CT schedule by obviating the need to acquire a longer delayed phase.

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  • The development of new CT protocols has improved the detection and characterization of adrenal masses.

    “The development of new CT protocols has improved the detection and characterization of adrenal masses (87).”

    From Adrenal incidentaloma (2020) · cites this paper as [87]

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  • Adrenal incidentaloma

    Sherlock, M., Scarsbrook, A., Abbas, A., Fraser, S., Limumpornpetch, P., Dineen, R., & Stewart, P. M. (2020) · Endocrine Reviews · doi:10.1210/endrev/bnaa008 · Cited by 347 · see citing works

    “The development of new CT protocols has improved the detection and characterization of adrenal masses (87).”

Related

Authors
Foti, G., Malleo, G., Faccioli, N., Guerriero, A., Furlani, L., & Carbognin, G.
Affiliations
  • Ospedale Sacro Cuore Don Calabria (IT)
  • University of Verona (IT)
Corresponding author
Foti, Giovanni
ORCID
Venue
La radiologia medica
Publisher
Springer Science and Business Media LLC
Published
2018-06-19
Volume
123
Issue
11
Pages
833-840
ISSN
  • 0033-8362 (ISSN-L)
  • 1826-6983
DOI
10.1007/s11547-018-0911-6
OpenAlex
W2809078965
Cited by
18
References
28
Citations by year
2024: 2 · 2023: 1 · 2022: 3 · 2021: 4 · 2020: 7 · 2019: 1
FWCI
3.14
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • La radiologia medica (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal cell carcinoma treatment
Keywords
adrenal mass, adrenal adenoma, multiphase CT, delayed phase, intermediate phase, diagnostic accuracy, adrenal metastasis, pheochromocytoma
MeSH terms
Adenoma, Adrenal Gland Neoplasms, Adult, Aged, Aged, 80 and over, Contrast Media, Diagnosis, Differential, Female, Humans, Iohexol, Male, Middle Aged, Neoplasm Staging, Pheochromocytoma, Prospective Studies, Radiographic Image Interpretation, Computer-Assisted, Sensitivity and Specificity, Tomography, X-Ray Computed

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