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Differentiation of Adrenal Adenoma and Nonadenoma in Unenhanced CT: New Optimal Threshold Value and the Usefulness of Size Criteria for Differentiation
Korean Journal of Radiology ; : 328-335, 2007.
Article in English | WPRIM | ID: wpr-211220
ABSTRACT

OBJECTIVE:

To determine the optimal threshold for the attenuation values in unenhanced computed tomography (CT) and assess the value of the size criteria for differentiating between an adrenal adenoma and a nonadenoma. MATERIALS AND

METHODS:

The unenhanced CT images of 45 patients at our institution, who underwent a surgical resection of an adrenal masses between January 2001 and July 2005, were retrospectively reviewed. Forty-five adrenal masses included 25 cortical adenomas, 12 pheochromocytomas, three lymphomas, and five metastases confirmed by pathology were examined. The CT images were obtained at a slice thickness of 2 mm to 3 mm. The mAs were varied from 100 to 160 and 200 to 280, while the 120 KVp was maintained in all cases. The mean attenuation values of an adrenal adenoma and nonadenoma were compared using an unpaired t test. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy at thresholds of 10 HU, 20 HU, and 25 HU were compared. The diagnostic accuracy according to the size criteria from 2 cm to 6 cm was also compared.

RESULTS:

The twenty-five adenomas showed significantly lower (p 90% but a specificity < 70%. Size criteria of 2 or 3 cm had a high specificity of 100% and 80% but a low sensitivity of 20% and 60%.

CONCLUSION:

The threshold attenuation values of 20 or 25 HU in the unenhanced CT appear optimal for discriminating an adrenal adenoma from a nonadenoma. The size criteria are of little value in differentiating adrenal masses because of their low specificity or low sensitivity.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Pheochromocytoma / Tomography, X-Ray Computed / Adenoma / Predictive Value of Tests / Retrospective Studies / Sensitivity and Specificity / Adrenal Gland Neoplasms / Adrenalectomy / Lymphoma Type of study: Diagnostic study / Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Female / Humans / Male Language: English Journal: Korean Journal of Radiology Year: 2007 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Pheochromocytoma / Tomography, X-Ray Computed / Adenoma / Predictive Value of Tests / Retrospective Studies / Sensitivity and Specificity / Adrenal Gland Neoplasms / Adrenalectomy / Lymphoma Type of study: Diagnostic study / Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Female / Humans / Male Language: English Journal: Korean Journal of Radiology Year: 2007 Type: Article