Differentiation between heterogeneous adrenal adenoma and non-adenoma adrenal lesion with CT and MRI
Purpose To assess whether heterogeneous adrenal adenomas can be distinguished from heterogeneous non-adenomas with Computed Tomography (CT) and/or Magnetic Resonance Imaging (MRI). Method From 2009 to 2019, 980 consecutive adrenalectomies were retrospectively identified. Patients without adequate CT...
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| Veröffentlicht in: | Abdominal imaging 2022-03, Vol.47 (3), p.1098-1111 |
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| creator | Lanoix, Justine Djelouah, Manel Chocardelle, Lea Deguelte, Sophie Delemer, Brigitte Dohan, Anthony Soyer, Philippe Barat, Maxime Hoeffel, Christine |
| description | Purpose
To assess whether heterogeneous adrenal adenomas can be distinguished from heterogeneous non-adenomas with Computed Tomography (CT) and/or Magnetic Resonance Imaging (MRI).
Method
From 2009 to 2019, 980 consecutive adrenalectomies were retrospectively identified. Patients without adequate CT/MRI, with homogeneous and/or |
| doi_str_mv | 10.1007/s00261-022-03409-4 |
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| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_03544282v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2620763056</sourcerecordid><originalsourceid>FETCH-LOGICAL-c409t-432d4d5e63da6d73d3eaded70f5cb8083bdd5b48724930fd7dded79ae0d489ec3</originalsourceid><addsrcrecordid>eNp9kU1r3DAQhkVoaUKaP9BDMPTSHpyOvu1j2DQfsKVQEshNyNY46-CVUsnb0H8feb3ZQA89jaR55h29vIR8onBGAfS3BMAULYGxEriAuhQH5IhxpUoAWb3bn8X9ITlJ6REAqJKUMvmBHHIJXNc1HBF30XcdRvRjb8c--KLB8RnRFyscMYYH9Bg2qbAuI3bIFX1Y28J6V_jgy_191x8wTSLP_bgqFrdb7Mevm4_kfWeHhCe7ekzuLr_fLq7L5c-rm8X5smyzgbEUnDnhJCrurHKaO45Z32noZNtUUPHGOdmISjNRc-icdlO3tghOVDW2_Jh8nXVXdjBPsV_b-NcE25vr86WZ3oBLIVjF_tDMfpnZpxh-bzCNZt2nFofBbh0bphhoxUGqjH7-B30Mm5jtThSnWmgGIlNsptoYUorY7X9AwUyRmTkykyMz28jMNHS6k940a3T7kdeAMsBnIOWWf8D4tvs_si8TNKCO</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2631747204</pqid></control><display><type>article</type><title>Differentiation between heterogeneous adrenal adenoma and non-adenoma adrenal lesion with CT and MRI</title><source>SpringerLink Journals - AutoHoldings</source><creator>Lanoix, Justine ; Djelouah, Manel ; Chocardelle, Lea ; Deguelte, Sophie ; Delemer, Brigitte ; Dohan, Anthony ; Soyer, Philippe ; Barat, Maxime ; Hoeffel, Christine</creator><creatorcontrib>Lanoix, Justine ; Djelouah, Manel ; Chocardelle, Lea ; Deguelte, Sophie ; Delemer, Brigitte ; Dohan, Anthony ; Soyer, Philippe ; Barat, Maxime ; Hoeffel, Christine</creatorcontrib><description>Purpose
To assess whether heterogeneous adrenal adenomas can be distinguished from heterogeneous non-adenomas with Computed Tomography (CT) and/or Magnetic Resonance Imaging (MRI).
Method
From 2009 to 2019, 980 consecutive adrenalectomies were retrospectively identified. Patients without adequate CT/MRI, with homogeneous and/or < 1 cm lesions were excluded. Differences between adenomas and non-adenomas were analyzed using Chi-square, Student
t
or Fischer tests, and interobserver agreement using weighted kappa test or intraclass correlation coefficient. Independent variables associated with adenomas were searched for using multivariable analysis. Area under the receiver operating characteristic curve (AUC) of the final model and its diagnostic performances were calculated.
Results
Final population comprised 183 patients (106 women, 77 men, mean age 53.2 ± 14.4 years) with 124 non-adenomas and 59 heterogeneous adenomas. Macroscopic or microscopic fat on CT/MRI allowed diagnosis of adenoma with 98% specificity and 63% sensitivity. Interobserver agreement was almost perfect for macroscopic fat (
k
= 0.82; 95% CI 0.66; 0.94) and substantial for microscopic fat (
k
= 0.75; 95% CI 0.62; 0.86). A multivariable model including micro- or macroscopic fat [Odds ratio (OR) 81.19; 95% CI 20.17; 572.27], diameter < 5.5 cm (OR 7.32; 95% CI 2.17; 31.28), calcifications (OR 5.68; 95% CI 2.08; 16.18), and hemorrhage (OR 3.10; 95% CI 0.70; 15.35) had an AUC of 0.91 (95% CI 0.86; 0.96), 71% (42/59, 95% CI 58; 82) sensitivity, 93% (115/124; 95% CI 87; 97) specificity, and 86% (157/183; 95% CI 79; 90) accuracy for the diagnosis of adenoma.
Conclusion
A multivariable model enables CT/MR diagnosis of heterogeneous adenomas. Presence of microscopic fat, even if partial, in a heterogeneous mass is highly specific of adenoma.
Graphical abstract</description><identifier>ISSN: 2366-004X</identifier><identifier>EISSN: 2366-0058</identifier><identifier>DOI: 10.1007/s00261-022-03409-4</identifier><identifier>PMID: 35037990</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adenoma ; Adrenal glands ; Bioengineering ; Bladder ; Computed tomography ; Correlation coefficient ; Correlation coefficients ; Diagnosis ; Gastroenterology ; Hemorrhage ; Hepatology ; Imaging ; Independent variables ; Kidneys ; Lesions ; Life Sciences ; Magnetic resonance imaging ; Medicine ; Medicine & Public Health ; Neuroendocrine tumors ; Radiology ; Retroperitoneum ; Sensitivity ; Tumors ; Ureters</subject><ispartof>Abdominal imaging, 2022-03, Vol.47 (3), p.1098-1111</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022</rights><rights>2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c409t-432d4d5e63da6d73d3eaded70f5cb8083bdd5b48724930fd7dded79ae0d489ec3</citedby><cites>FETCH-LOGICAL-c409t-432d4d5e63da6d73d3eaded70f5cb8083bdd5b48724930fd7dded79ae0d489ec3</cites><orcidid>0000-0002-0783-0723 ; 0000-0002-8732-5603 ; 0000-0002-2551-3545</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00261-022-03409-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00261-022-03409-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35037990$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03544282$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Lanoix, Justine</creatorcontrib><creatorcontrib>Djelouah, Manel</creatorcontrib><creatorcontrib>Chocardelle, Lea</creatorcontrib><creatorcontrib>Deguelte, Sophie</creatorcontrib><creatorcontrib>Delemer, Brigitte</creatorcontrib><creatorcontrib>Dohan, Anthony</creatorcontrib><creatorcontrib>Soyer, Philippe</creatorcontrib><creatorcontrib>Barat, Maxime</creatorcontrib><creatorcontrib>Hoeffel, Christine</creatorcontrib><title>Differentiation between heterogeneous adrenal adenoma and non-adenoma adrenal lesion with CT and MRI</title><title>Abdominal imaging</title><addtitle>Abdom Radiol</addtitle><addtitle>Abdom Radiol (NY)</addtitle><description>Purpose
To assess whether heterogeneous adrenal adenomas can be distinguished from heterogeneous non-adenomas with Computed Tomography (CT) and/or Magnetic Resonance Imaging (MRI).
Method
From 2009 to 2019, 980 consecutive adrenalectomies were retrospectively identified. Patients without adequate CT/MRI, with homogeneous and/or < 1 cm lesions were excluded. Differences between adenomas and non-adenomas were analyzed using Chi-square, Student
t
or Fischer tests, and interobserver agreement using weighted kappa test or intraclass correlation coefficient. Independent variables associated with adenomas were searched for using multivariable analysis. Area under the receiver operating characteristic curve (AUC) of the final model and its diagnostic performances were calculated.
Results
Final population comprised 183 patients (106 women, 77 men, mean age 53.2 ± 14.4 years) with 124 non-adenomas and 59 heterogeneous adenomas. Macroscopic or microscopic fat on CT/MRI allowed diagnosis of adenoma with 98% specificity and 63% sensitivity. Interobserver agreement was almost perfect for macroscopic fat (
k
= 0.82; 95% CI 0.66; 0.94) and substantial for microscopic fat (
k
= 0.75; 95% CI 0.62; 0.86). A multivariable model including micro- or macroscopic fat [Odds ratio (OR) 81.19; 95% CI 20.17; 572.27], diameter < 5.5 cm (OR 7.32; 95% CI 2.17; 31.28), calcifications (OR 5.68; 95% CI 2.08; 16.18), and hemorrhage (OR 3.10; 95% CI 0.70; 15.35) had an AUC of 0.91 (95% CI 0.86; 0.96), 71% (42/59, 95% CI 58; 82) sensitivity, 93% (115/124; 95% CI 87; 97) specificity, and 86% (157/183; 95% CI 79; 90) accuracy for the diagnosis of adenoma.
Conclusion
A multivariable model enables CT/MR diagnosis of heterogeneous adenomas. Presence of microscopic fat, even if partial, in a heterogeneous mass is highly specific of adenoma.
Graphical abstract</description><subject>Adenoma</subject><subject>Adrenal glands</subject><subject>Bioengineering</subject><subject>Bladder</subject><subject>Computed tomography</subject><subject>Correlation coefficient</subject><subject>Correlation coefficients</subject><subject>Diagnosis</subject><subject>Gastroenterology</subject><subject>Hemorrhage</subject><subject>Hepatology</subject><subject>Imaging</subject><subject>Independent variables</subject><subject>Kidneys</subject><subject>Lesions</subject><subject>Life Sciences</subject><subject>Magnetic resonance imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroendocrine tumors</subject><subject>Radiology</subject><subject>Retroperitoneum</subject><subject>Sensitivity</subject><subject>Tumors</subject><subject>Ureters</subject><issn>2366-004X</issn><issn>2366-0058</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kU1r3DAQhkVoaUKaP9BDMPTSHpyOvu1j2DQfsKVQEshNyNY46-CVUsnb0H8feb3ZQA89jaR55h29vIR8onBGAfS3BMAULYGxEriAuhQH5IhxpUoAWb3bn8X9ITlJ6REAqJKUMvmBHHIJXNc1HBF30XcdRvRjb8c--KLB8RnRFyscMYYH9Bg2qbAuI3bIFX1Y28J6V_jgy_191x8wTSLP_bgqFrdb7Mevm4_kfWeHhCe7ekzuLr_fLq7L5c-rm8X5smyzgbEUnDnhJCrurHKaO45Z32noZNtUUPHGOdmISjNRc-icdlO3tghOVDW2_Jh8nXVXdjBPsV_b-NcE25vr86WZ3oBLIVjF_tDMfpnZpxh-bzCNZt2nFofBbh0bphhoxUGqjH7-B30Mm5jtThSnWmgGIlNsptoYUorY7X9AwUyRmTkykyMz28jMNHS6k940a3T7kdeAMsBnIOWWf8D4tvs_si8TNKCO</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Lanoix, Justine</creator><creator>Djelouah, Manel</creator><creator>Chocardelle, Lea</creator><creator>Deguelte, Sophie</creator><creator>Delemer, Brigitte</creator><creator>Dohan, Anthony</creator><creator>Soyer, Philippe</creator><creator>Barat, Maxime</creator><creator>Hoeffel, Christine</creator><general>Springer US</general><general>Springer Nature B.V</general><general>Springer</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-0783-0723</orcidid><orcidid>https://orcid.org/0000-0002-8732-5603</orcidid><orcidid>https://orcid.org/0000-0002-2551-3545</orcidid></search><sort><creationdate>20220301</creationdate><title>Differentiation between heterogeneous adrenal adenoma and non-adenoma adrenal lesion with CT and MRI</title><author>Lanoix, Justine ; Djelouah, Manel ; Chocardelle, Lea ; Deguelte, Sophie ; Delemer, Brigitte ; Dohan, Anthony ; Soyer, Philippe ; Barat, Maxime ; Hoeffel, Christine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c409t-432d4d5e63da6d73d3eaded70f5cb8083bdd5b48724930fd7dded79ae0d489ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adenoma</topic><topic>Adrenal glands</topic><topic>Bioengineering</topic><topic>Bladder</topic><topic>Computed tomography</topic><topic>Correlation coefficient</topic><topic>Correlation coefficients</topic><topic>Diagnosis</topic><topic>Gastroenterology</topic><topic>Hemorrhage</topic><topic>Hepatology</topic><topic>Imaging</topic><topic>Independent variables</topic><topic>Kidneys</topic><topic>Lesions</topic><topic>Life Sciences</topic><topic>Magnetic resonance imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroendocrine tumors</topic><topic>Radiology</topic><topic>Retroperitoneum</topic><topic>Sensitivity</topic><topic>Tumors</topic><topic>Ureters</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lanoix, Justine</creatorcontrib><creatorcontrib>Djelouah, Manel</creatorcontrib><creatorcontrib>Chocardelle, Lea</creatorcontrib><creatorcontrib>Deguelte, Sophie</creatorcontrib><creatorcontrib>Delemer, Brigitte</creatorcontrib><creatorcontrib>Dohan, Anthony</creatorcontrib><creatorcontrib>Soyer, Philippe</creatorcontrib><creatorcontrib>Barat, Maxime</creatorcontrib><creatorcontrib>Hoeffel, Christine</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical 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1</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Abdominal imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lanoix, Justine</au><au>Djelouah, Manel</au><au>Chocardelle, Lea</au><au>Deguelte, Sophie</au><au>Delemer, Brigitte</au><au>Dohan, Anthony</au><au>Soyer, Philippe</au><au>Barat, Maxime</au><au>Hoeffel, Christine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differentiation between heterogeneous adrenal adenoma and non-adenoma adrenal lesion with CT and MRI</atitle><jtitle>Abdominal imaging</jtitle><stitle>Abdom Radiol</stitle><addtitle>Abdom Radiol (NY)</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>47</volume><issue>3</issue><spage>1098</spage><epage>1111</epage><pages>1098-1111</pages><issn>2366-004X</issn><eissn>2366-0058</eissn><abstract>Purpose
To assess whether heterogeneous adrenal adenomas can be distinguished from heterogeneous non-adenomas with Computed Tomography (CT) and/or Magnetic Resonance Imaging (MRI).
Method
From 2009 to 2019, 980 consecutive adrenalectomies were retrospectively identified. Patients without adequate CT/MRI, with homogeneous and/or < 1 cm lesions were excluded. Differences between adenomas and non-adenomas were analyzed using Chi-square, Student
t
or Fischer tests, and interobserver agreement using weighted kappa test or intraclass correlation coefficient. Independent variables associated with adenomas were searched for using multivariable analysis. Area under the receiver operating characteristic curve (AUC) of the final model and its diagnostic performances were calculated.
Results
Final population comprised 183 patients (106 women, 77 men, mean age 53.2 ± 14.4 years) with 124 non-adenomas and 59 heterogeneous adenomas. Macroscopic or microscopic fat on CT/MRI allowed diagnosis of adenoma with 98% specificity and 63% sensitivity. Interobserver agreement was almost perfect for macroscopic fat (
k
= 0.82; 95% CI 0.66; 0.94) and substantial for microscopic fat (
k
= 0.75; 95% CI 0.62; 0.86). A multivariable model including micro- or macroscopic fat [Odds ratio (OR) 81.19; 95% CI 20.17; 572.27], diameter < 5.5 cm (OR 7.32; 95% CI 2.17; 31.28), calcifications (OR 5.68; 95% CI 2.08; 16.18), and hemorrhage (OR 3.10; 95% CI 0.70; 15.35) had an AUC of 0.91 (95% CI 0.86; 0.96), 71% (42/59, 95% CI 58; 82) sensitivity, 93% (115/124; 95% CI 87; 97) specificity, and 86% (157/183; 95% CI 79; 90) accuracy for the diagnosis of adenoma.
Conclusion
A multivariable model enables CT/MR diagnosis of heterogeneous adenomas. Presence of microscopic fat, even if partial, in a heterogeneous mass is highly specific of adenoma.
Graphical abstract</abstract><cop>New York</cop><pub>Springer US</pub><pmid>35037990</pmid><doi>10.1007/s00261-022-03409-4</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-0783-0723</orcidid><orcidid>https://orcid.org/0000-0002-8732-5603</orcidid><orcidid>https://orcid.org/0000-0002-2551-3545</orcidid></addata></record> |
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| ispartof | Abdominal imaging, 2022-03, Vol.47 (3), p.1098-1111 |
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| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_03544282v1 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Adenoma Adrenal glands Bioengineering Bladder Computed tomography Correlation coefficient Correlation coefficients Diagnosis Gastroenterology Hemorrhage Hepatology Imaging Independent variables Kidneys Lesions Life Sciences Magnetic resonance imaging Medicine Medicine & Public Health Neuroendocrine tumors Radiology Retroperitoneum Sensitivity Tumors Ureters |
| title | Differentiation between heterogeneous adrenal adenoma and non-adenoma adrenal lesion with CT and MRI |
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