Characterization of lipid-poor adrenal adenoma: chemical-shift MRI and washout CT
Abstract
OBJECTIVE: The purpose of this article is to retrospectively compare the accuracy of MRI and CT in characterizing lipid-poor adrenal adenomas with respect to lesion-attenuation values measured on unenhanced CT. MATERIALS AND METHODS: Fifty-two lipid-poor adrenal masses measuring greater than 10 HU on unenhanced CT were identified in 52 patients who underwent both chemical-shift MRI and washout CT. Accuracies using the adrenal-to-spleen ratio (< 0.71) or signal intensity index (> 16.5%) for MRI and using absolute (≥ 60%) or relative (≥ 40%) percentage washout for CT were calculated to determine which modality was more accurate for lipid-poor adenoma characterization. Sensitivities of MRI and CT were also compared according to the lesion-attenuation values measured on unenhanced CT. Follow-up imaging or histologic diagnosis was used as the standard reference. The McNemar test was used to compare the accuracies of CT and MRI. RESULTS: Lipid-poor adrenal masses consisted of 37 adenomas and 15 nonadenomas. The sensitivities and specificities for adenoma on MRI versus CT were 75.7% (28/37) versus 100% (37/37) and 60.0% (9/15) versus 80.0% (12/15), respectively. CT achieved a higher accuracy than did MRI (p = 0.008). The sensitivities for adenomas measuring 20 HU or less on unenhanced CT were 100% (12/12) in both MRI and CT, whereas those measuring more than 20 HU were 64.0% (16/25) and 100% (25/25) in MRI and CT, respectively. CONCLUSION: MRI is equivalent to CT for characterizing adenomas measuring 20 HU or less on unenhanced CT. However, MRI is inferior to CT for adenomas measuring more than 20 HU because of decreased MR sensitivity.
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Dedicated adrenal washout protocol CT is more accurate for characterizing lipid-poor adenomas than MRI.
“Our institutional practice is to perform a dedicated adrenal washout protocol CT as the next test because this is more accurate for characterizing lipid-poor adenomas than MRI (297)”
From Adrenal incidentaloma (2020) · cites this paper as [297]
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Multiple Endocrine Neoplasia: Spectrum of Abdominal Manifestations
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Adrenal imaging: anatomy and pathology (literature review)
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Self-citationA Thymic Hyperplasia Case without Suppressing on Chemical Shift Magnetic Resonance Imaging
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New radiologic classification of renal angiomyolipoma: frequently asked questions
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Self-citationPredictive Factors of Functioning Adrenal Incidentaloma: A 15-Year Retrospective Study
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Non-contrast spectral CT vs chemical-shift MRI in discriminating lipid-poor adrenal lesions
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Optimal and novel imaging of the adrenal glands
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Management of the patient with incidental bilateral adrenal nodules
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Clinical presentation, management, and research progress of adrenal schwannoma
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A radiomic signature based on magnetic resonance imaging to determine adrenal Cushing’s syndrome
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Frequency of lipid-poor adrenal adenomas in magnetic resonance imaging examinations of the abdomen
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Imaging of Adrenocortical Carcinoma: An Update
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Recent Development of CXCR4-Targeted Nuclear Medicine Research in Adrenocortical Tumors
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Imaging Modalities for Adrenocortical Tumors
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Reply: Can Angiomyolipomas be classified fully into three types?
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Self-citationChemical-shift Imaging: does it have a role in the management of adrenal masses?
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Adrenal Incidentaloma: Imaging Approach and Differential Diagnosis
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- Authors
- Seo, J. M., Park, B. K., Park, S. Y., & Kim, C. K.
- Affiliations
- Samsung Medical Center (KR)
- Venue
- American Journal of Roentgenology
- Publisher
- American Roentgen Ray Society
- Published
- 2014-05
- Volume
- 202
- Issue
- 5
- Pages
- 1043-1050
- ISSN
- 0002-9580 (ISSN-L)
- 0361-803X
- 1546-3141
- OpenAlex
- W1971173090
- Cited by
- 130
- References
- 25
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 15 · 2023: 9 · 2022: 19 · 2021: 9 · 2020: 13 · 2019: 8 · 2018: 11 · 2017: 9 · 2016: 13 · 2015: 4 · 2014: 4
- FWCI
- 9.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Roentgenology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › MRI in cancer diagnosis
- Keywords
- adrenal mass, chemical shift MRI, diagnostic accuracy
- MeSH terms
- Adenoma, Adrenal Gland Neoplasms, Female, Humans, Lipids, Magnetic Resonance Imaging, Male, Middle Aged, Retrospective Studies, Tomography, X-Ray Computed, Reproducibility of Results
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