Inter-individual comparison of diagnostic accuracy of adrenal washout CT compared to chemical shift MRI plus the T2-weighted (T2W) adrenal MRI calculator in indeterminate adrenal masses: a retrospective non-inferiority study
Objective To compare diagnostic accuracy of washout (WO)-CT to chemical shift (CS)-MRI + T2W adrenal MRI Calculator (T2W-Calculator) to diagnose adrenal adenoma in indeterminate adrenal masses. Methods This retrospective, cross-sectional, non-inferiority study evaluated 40 consecutive indeterminate...
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| Veröffentlicht in: | Abdominal imaging 2022-07, Vol.47 (7), p.2453-2461 |
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| creator | McPhedran, Rachel Gerson, Rosalind Alfaleh, Hana Sathiadoss, Paul Schieda, Nicola |
| description | Objective
To compare diagnostic accuracy of washout (WO)-CT to chemical shift (CS)-MRI + T2W adrenal MRI Calculator (T2W-Calculator) to diagnose adrenal adenoma in indeterminate adrenal masses.
Methods
This retrospective, cross-sectional, non-inferiority study evaluated 40 consecutive indeterminate adrenal masses; each with WO-CT and MRI. Two blinded radiologists independently evaluated in mixed order: pre-contrast attenuation (Hounsfield Units, HU) and absolute WO ([Peak.HU-Delay.HU]/[Peak.HU-Pre.HU] × 100%), Chemical Shift Signal Intensity (CS-SI) Index, T2W SI ratio, and Entropy (which were imputed into the T2W-Calculator). Diagnostic accuracy for adrenal adenoma was tabulated using 2 × 2 tables. True -positive diagnoses of adenoma were CT = Pre-HU |
| doi_str_mv | 10.1007/s00261-022-03533-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2661955975</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2679958082</sourcerecordid><originalsourceid>FETCH-LOGICAL-c282t-f4bd1e64805d778117d31c38f371cdb7bf807be06b6d08003707cd9303a20c493</originalsourceid><addsrcrecordid>eNp9kVFrFDEUhQdRsNT-AZ8CvtSHqTfJzmTGN1msLlQEWfFxyCR3dlJmkjU307L_1p_SrFuq-CAEbsj9ziGHUxSvOVxxAPWOAETNSxCiBFlJWfJnxZmQdV0CVM3zv-4viwuiWwDgdcW5qM6KXxufMJbOW3fn7KInZsK819FR8CwMzDq984GSM0wbs0RtDsdnbSP6DN9rGsOS2Hr7qEPLUmBmxNmZvKfRDYl9-bZh-2khlkZkW1Heo9uNKaOXW_Hj7ZPZEcsis0w6hcicz8di_t7svE74xM2aCOk90yxiioH2aJK7Q-aDz0EGjC5Elw6M0mIPr4oXg54ILx7nefH9-uN2_bm8-fpps_5wUxrRiFQOq95yrFcNVFaphnNlJTeyGaTixvaqHxpQPULd1xYaAKlAGdtKkFqAWbXyvLg8-e5j-LkgpW52ZHCatMewUCfqmrdV1aoqo2_-QW_DEnOyI6XatmqgEZkSJ8rkiBRx6PbRzToeOg7dsffu1HuXe-9-997xLJInEWXY7zD-sf6P6gGZHLN6</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2679958082</pqid></control><display><type>article</type><title>Inter-individual comparison of diagnostic accuracy of adrenal washout CT compared to chemical shift MRI plus the T2-weighted (T2W) adrenal MRI calculator in indeterminate adrenal masses: a retrospective non-inferiority study</title><source>SpringerLink Journals</source><creator>McPhedran, Rachel ; Gerson, Rosalind ; Alfaleh, Hana ; Sathiadoss, Paul ; Schieda, Nicola</creator><creatorcontrib>McPhedran, Rachel ; Gerson, Rosalind ; Alfaleh, Hana ; Sathiadoss, Paul ; Schieda, Nicola</creatorcontrib><description>Objective
To compare diagnostic accuracy of washout (WO)-CT to chemical shift (CS)-MRI + T2W adrenal MRI Calculator (T2W-Calculator) to diagnose adrenal adenoma in indeterminate adrenal masses.
Methods
This retrospective, cross-sectional, non-inferiority study evaluated 40 consecutive indeterminate adrenal masses; each with WO-CT and MRI. Two blinded radiologists independently evaluated in mixed order: pre-contrast attenuation (Hounsfield Units, HU) and absolute WO ([Peak.HU-Delay.HU]/[Peak.HU-Pre.HU] × 100%), Chemical Shift Signal Intensity (CS-SI) Index, T2W SI ratio, and Entropy (which were imputed into the T2W-Calculator). Diagnostic accuracy for adrenal adenoma was tabulated using 2 × 2 tables. True -positive diagnoses of adenoma were CT = Pre-HU < 10 or absolute WO ≥ 60%, MRI = SI index ≥ 16.5% or T2W-Calculator < 0.631.
Results
There were 73% (29/40) adenomas and 27% (11/40) other masses (5 pheochromocytoma, 3 solitary fibrous tumor, 1 metastasis, 1 cavernous hemangioma, and 1 adrenocortical carcinoma). Sensitivity, specificity, and accuracy for diagnosis of adenoma using CT-WO were 78% (95% confidence intervals [CI] 56–93%), 35% (14–62%), and 57% (42–71%) Reader 1 and 72% (53–87%), 46% (17–77%), and 59% (41–76%) Reader 2. Sensitivity, specificity, and accuracy for diagnosis of adenoma using MRI were 100% (88–100%), 64% (34–90%), and 82% (67–97%) Reader 1 and 86% (68–96%), 73% (39–94%), and 80% (64–95%) Reader 2. MRI had higher overall accuracy (
p
= 0.02 Reader 1, 0.05 Reader 2) compared to CT-WO.
Conclusion
Chemical shift MRI combined with the T2W adrenal MRI calculator is not inferior to CT Washout for diagnosis of adrenal adenoma among indeterminate adrenal masses.</description><identifier>ISSN: 2366-0058</identifier><identifier>ISSN: 2366-004X</identifier><identifier>EISSN: 2366-0058</identifier><identifier>DOI: 10.1007/s00261-022-03533-1</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Accuracy ; Adenoma ; Bladder ; Chemical equilibrium ; Computed tomography ; Confidence intervals ; Diagnosis ; Diagnostic systems ; Entropy ; Gastroenterology ; Hemangioma ; Hepatology ; Imaging ; Kidneys ; Magnetic resonance imaging ; Mathematical analysis ; Medical diagnosis ; Medicine ; Medicine & Public Health ; Metastases ; Neuroendocrine tumors ; Pheochromocytoma ; Radiology ; Retroperitoneum ; Sensitivity ; Tumors ; Ureters</subject><ispartof>Abdominal imaging, 2022-07, Vol.47 (7), p.2453-2461</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c282t-f4bd1e64805d778117d31c38f371cdb7bf807be06b6d08003707cd9303a20c493</citedby><cites>FETCH-LOGICAL-c282t-f4bd1e64805d778117d31c38f371cdb7bf807be06b6d08003707cd9303a20c493</cites><orcidid>0000-0002-2653-4786</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/s00261-022-03533-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00261-022-03533-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>McPhedran, Rachel</creatorcontrib><creatorcontrib>Gerson, Rosalind</creatorcontrib><creatorcontrib>Alfaleh, Hana</creatorcontrib><creatorcontrib>Sathiadoss, Paul</creatorcontrib><creatorcontrib>Schieda, Nicola</creatorcontrib><title>Inter-individual comparison of diagnostic accuracy of adrenal washout CT compared to chemical shift MRI plus the T2-weighted (T2W) adrenal MRI calculator in indeterminate adrenal masses: a retrospective non-inferiority study</title><title>Abdominal imaging</title><addtitle>Abdom Radiol</addtitle><description>Objective
To compare diagnostic accuracy of washout (WO)-CT to chemical shift (CS)-MRI + T2W adrenal MRI Calculator (T2W-Calculator) to diagnose adrenal adenoma in indeterminate adrenal masses.
Methods
This retrospective, cross-sectional, non-inferiority study evaluated 40 consecutive indeterminate adrenal masses; each with WO-CT and MRI. Two blinded radiologists independently evaluated in mixed order: pre-contrast attenuation (Hounsfield Units, HU) and absolute WO ([Peak.HU-Delay.HU]/[Peak.HU-Pre.HU] × 100%), Chemical Shift Signal Intensity (CS-SI) Index, T2W SI ratio, and Entropy (which were imputed into the T2W-Calculator). Diagnostic accuracy for adrenal adenoma was tabulated using 2 × 2 tables. True -positive diagnoses of adenoma were CT = Pre-HU < 10 or absolute WO ≥ 60%, MRI = SI index ≥ 16.5% or T2W-Calculator < 0.631.
Results
There were 73% (29/40) adenomas and 27% (11/40) other masses (5 pheochromocytoma, 3 solitary fibrous tumor, 1 metastasis, 1 cavernous hemangioma, and 1 adrenocortical carcinoma). Sensitivity, specificity, and accuracy for diagnosis of adenoma using CT-WO were 78% (95% confidence intervals [CI] 56–93%), 35% (14–62%), and 57% (42–71%) Reader 1 and 72% (53–87%), 46% (17–77%), and 59% (41–76%) Reader 2. Sensitivity, specificity, and accuracy for diagnosis of adenoma using MRI were 100% (88–100%), 64% (34–90%), and 82% (67–97%) Reader 1 and 86% (68–96%), 73% (39–94%), and 80% (64–95%) Reader 2. MRI had higher overall accuracy (
p
= 0.02 Reader 1, 0.05 Reader 2) compared to CT-WO.
Conclusion
Chemical shift MRI combined with the T2W adrenal MRI calculator is not inferior to CT Washout for diagnosis of adrenal adenoma among indeterminate adrenal masses.</description><subject>Accuracy</subject><subject>Adenoma</subject><subject>Bladder</subject><subject>Chemical equilibrium</subject><subject>Computed tomography</subject><subject>Confidence intervals</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Entropy</subject><subject>Gastroenterology</subject><subject>Hemangioma</subject><subject>Hepatology</subject><subject>Imaging</subject><subject>Kidneys</subject><subject>Magnetic resonance imaging</subject><subject>Mathematical analysis</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Neuroendocrine tumors</subject><subject>Pheochromocytoma</subject><subject>Radiology</subject><subject>Retroperitoneum</subject><subject>Sensitivity</subject><subject>Tumors</subject><subject>Ureters</subject><issn>2366-0058</issn><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>eNp9kVFrFDEUhQdRsNT-AZ8CvtSHqTfJzmTGN1msLlQEWfFxyCR3dlJmkjU307L_1p_SrFuq-CAEbsj9ziGHUxSvOVxxAPWOAETNSxCiBFlJWfJnxZmQdV0CVM3zv-4viwuiWwDgdcW5qM6KXxufMJbOW3fn7KInZsK819FR8CwMzDq984GSM0wbs0RtDsdnbSP6DN9rGsOS2Hr7qEPLUmBmxNmZvKfRDYl9-bZh-2khlkZkW1Heo9uNKaOXW_Hj7ZPZEcsis0w6hcicz8di_t7svE74xM2aCOk90yxiioH2aJK7Q-aDz0EGjC5Elw6M0mIPr4oXg54ILx7nefH9-uN2_bm8-fpps_5wUxrRiFQOq95yrFcNVFaphnNlJTeyGaTixvaqHxpQPULd1xYaAKlAGdtKkFqAWbXyvLg8-e5j-LkgpW52ZHCatMewUCfqmrdV1aoqo2_-QW_DEnOyI6XatmqgEZkSJ8rkiBRx6PbRzToeOg7dsffu1HuXe-9-997xLJInEWXY7zD-sf6P6gGZHLN6</recordid><startdate>20220701</startdate><enddate>20220701</enddate><creator>McPhedran, Rachel</creator><creator>Gerson, Rosalind</creator><creator>Alfaleh, Hana</creator><creator>Sathiadoss, Paul</creator><creator>Schieda, Nicola</creator><general>Springer US</general><general>Springer Nature B.V</general><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><orcidid>https://orcid.org/0000-0002-2653-4786</orcidid></search><sort><creationdate>20220701</creationdate><title>Inter-individual comparison of diagnostic accuracy of adrenal washout CT compared to chemical shift MRI plus the T2-weighted (T2W) adrenal MRI calculator in indeterminate adrenal masses: a retrospective non-inferiority study</title><author>McPhedran, Rachel ; Gerson, Rosalind ; Alfaleh, Hana ; Sathiadoss, Paul ; Schieda, Nicola</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c282t-f4bd1e64805d778117d31c38f371cdb7bf807be06b6d08003707cd9303a20c493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Accuracy</topic><topic>Adenoma</topic><topic>Bladder</topic><topic>Chemical equilibrium</topic><topic>Computed tomography</topic><topic>Confidence intervals</topic><topic>Diagnosis</topic><topic>Diagnostic systems</topic><topic>Entropy</topic><topic>Gastroenterology</topic><topic>Hemangioma</topic><topic>Hepatology</topic><topic>Imaging</topic><topic>Kidneys</topic><topic>Magnetic resonance imaging</topic><topic>Mathematical analysis</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Neuroendocrine tumors</topic><topic>Pheochromocytoma</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>McPhedran, Rachel</creatorcontrib><creatorcontrib>Gerson, Rosalind</creatorcontrib><creatorcontrib>Alfaleh, Hana</creatorcontrib><creatorcontrib>Sathiadoss, Paul</creatorcontrib><creatorcontrib>Schieda, Nicola</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Computer Science Collection</collection><collection>Computer Science Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Biochemistry Abstracts 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><jtitle>Abdominal imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McPhedran, Rachel</au><au>Gerson, Rosalind</au><au>Alfaleh, Hana</au><au>Sathiadoss, Paul</au><au>Schieda, Nicola</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inter-individual comparison of diagnostic accuracy of adrenal washout CT compared to chemical shift MRI plus the T2-weighted (T2W) adrenal MRI calculator in indeterminate adrenal masses: a retrospective non-inferiority study</atitle><jtitle>Abdominal imaging</jtitle><stitle>Abdom Radiol</stitle><date>2022-07-01</date><risdate>2022</risdate><volume>47</volume><issue>7</issue><spage>2453</spage><epage>2461</epage><pages>2453-2461</pages><issn>2366-0058</issn><issn>2366-004X</issn><eissn>2366-0058</eissn><abstract>Objective
To compare diagnostic accuracy of washout (WO)-CT to chemical shift (CS)-MRI + T2W adrenal MRI Calculator (T2W-Calculator) to diagnose adrenal adenoma in indeterminate adrenal masses.
Methods
This retrospective, cross-sectional, non-inferiority study evaluated 40 consecutive indeterminate adrenal masses; each with WO-CT and MRI. Two blinded radiologists independently evaluated in mixed order: pre-contrast attenuation (Hounsfield Units, HU) and absolute WO ([Peak.HU-Delay.HU]/[Peak.HU-Pre.HU] × 100%), Chemical Shift Signal Intensity (CS-SI) Index, T2W SI ratio, and Entropy (which were imputed into the T2W-Calculator). Diagnostic accuracy for adrenal adenoma was tabulated using 2 × 2 tables. True -positive diagnoses of adenoma were CT = Pre-HU < 10 or absolute WO ≥ 60%, MRI = SI index ≥ 16.5% or T2W-Calculator < 0.631.
Results
There were 73% (29/40) adenomas and 27% (11/40) other masses (5 pheochromocytoma, 3 solitary fibrous tumor, 1 metastasis, 1 cavernous hemangioma, and 1 adrenocortical carcinoma). Sensitivity, specificity, and accuracy for diagnosis of adenoma using CT-WO were 78% (95% confidence intervals [CI] 56–93%), 35% (14–62%), and 57% (42–71%) Reader 1 and 72% (53–87%), 46% (17–77%), and 59% (41–76%) Reader 2. Sensitivity, specificity, and accuracy for diagnosis of adenoma using MRI were 100% (88–100%), 64% (34–90%), and 82% (67–97%) Reader 1 and 86% (68–96%), 73% (39–94%), and 80% (64–95%) Reader 2. MRI had higher overall accuracy (
p
= 0.02 Reader 1, 0.05 Reader 2) compared to CT-WO.
Conclusion
Chemical shift MRI combined with the T2W adrenal MRI calculator is not inferior to CT Washout for diagnosis of adrenal adenoma among indeterminate adrenal masses.</abstract><cop>New York</cop><pub>Springer US</pub><doi>10.1007/s00261-022-03533-1</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2653-4786</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Abdominal imaging, 2022-07, Vol.47 (7), p.2453-2461 |
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| subjects | Accuracy Adenoma Bladder Chemical equilibrium Computed tomography Confidence intervals Diagnosis Diagnostic systems Entropy Gastroenterology Hemangioma Hepatology Imaging Kidneys Magnetic resonance imaging Mathematical analysis Medical diagnosis Medicine Medicine & Public Health Metastases Neuroendocrine tumors Pheochromocytoma Radiology Retroperitoneum Sensitivity Tumors Ureters |
| title | Inter-individual comparison of diagnostic accuracy of adrenal washout CT compared to chemical shift MRI plus the T2-weighted (T2W) adrenal MRI calculator in indeterminate adrenal masses: a retrospective non-inferiority study |
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