Purpose: To retrospectively evaluate the diagnostic accuracy of quadriphasic computed tomography (CT) exam, in distinguishing adrenal adenomas from nonadenomas. Methods and Materials: This retrospective study had institutional review board approval; the need for informed consent was waived. One-hundred-four adrenal masses were evaluated in 87 patients (49 M, 38 F, mean age 58 years) undergoing unenhanced (UE), arterial enhanced (AE, 35 sec), portal enhanced (PE, 80 sec) and delayed enhanced (DE, 5-minutes) scans. Diagnosis was achieved with percutaneous biopsy (11), surgery (19), 1 year imaging follow-up (74). Attenuation values were measured in each phase with a ROI covering 1/2 to 2/3 of the lesion by two readers. The best thresholds and relative diagnostic accuracy in distinguishing adenomas from nonadenomas were retrospectively determined for wash-in and wash-out parameters using ROC curves. The accuracy of quadriphasic and other triphasic protocols were compared with Mann-Whitney U test. A value of p <0.05 was considered significant. Results: The diagnosis was 65 adenomas (51 lipid-rich, 14 lipid-poor), and 39 nonadenomas (33 metastases, 6 pheochromocytomas). The best imaging parameter for differential diagnosis was relative percentage wash-out (by using 30 % threshold, sensitivity 92.3%, specificity 92.9%, accuracy 92.5%). A total of 101/104 adrenal lesions were correctly characterized by using the quadriphasic protocol, with a significant increase in diagnostic accuracy with respect with other triphasic imaging protocols obtainable with any combination of the scans acquired (p=0.039). Conclusions: The quadriphasic dedicated adrenal CT study proposed may increase diagnostic accuracy in differentiating adenomas from nonadenomas if compared to other triphasic protocols.

The role of quadriphasic contrast enhanced computed tomography in distinguishing adrenal adenomas from nonadenomas

FACCIOLI, Niccolò;MANTOVANI, William;MANFREDI, Riccardo;POZZI MUCELLI, Roberto
2011-01-01

Abstract

Purpose: To retrospectively evaluate the diagnostic accuracy of quadriphasic computed tomography (CT) exam, in distinguishing adrenal adenomas from nonadenomas. Methods and Materials: This retrospective study had institutional review board approval; the need for informed consent was waived. One-hundred-four adrenal masses were evaluated in 87 patients (49 M, 38 F, mean age 58 years) undergoing unenhanced (UE), arterial enhanced (AE, 35 sec), portal enhanced (PE, 80 sec) and delayed enhanced (DE, 5-minutes) scans. Diagnosis was achieved with percutaneous biopsy (11), surgery (19), 1 year imaging follow-up (74). Attenuation values were measured in each phase with a ROI covering 1/2 to 2/3 of the lesion by two readers. The best thresholds and relative diagnostic accuracy in distinguishing adenomas from nonadenomas were retrospectively determined for wash-in and wash-out parameters using ROC curves. The accuracy of quadriphasic and other triphasic protocols were compared with Mann-Whitney U test. A value of p <0.05 was considered significant. Results: The diagnosis was 65 adenomas (51 lipid-rich, 14 lipid-poor), and 39 nonadenomas (33 metastases, 6 pheochromocytomas). The best imaging parameter for differential diagnosis was relative percentage wash-out (by using 30 % threshold, sensitivity 92.3%, specificity 92.9%, accuracy 92.5%). A total of 101/104 adrenal lesions were correctly characterized by using the quadriphasic protocol, with a significant increase in diagnostic accuracy with respect with other triphasic imaging protocols obtainable with any combination of the scans acquired (p=0.039). Conclusions: The quadriphasic dedicated adrenal CT study proposed may increase diagnostic accuracy in differentiating adenomas from nonadenomas if compared to other triphasic protocols.
2011
Adrenals; CT; Contrast agent-intravenous
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/349169
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