ArticleEuropean radiology2021
Hyperattenuating adrenal lesions in lung cancer: biphasic CT with unenhanced and 1-min enhanced images reliably predicts benign lesions.
Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- Feasibility of extracellular volume fraction derived from single-phase spectral CT for differentiating between adrenal metastases and adenomas.Abdominal radiology (New York) · 2025Article
- Clinical‑imaging‑radiomic nomogram based on unenhanced CT effectively predicts adrenal metastases in patients with lung cancer with small hyperattenuating adrenal incidentalomas.Oncology letters · 2024Article
- Diagnostic performance of hepatic CT and chemical-shift MRI to discriminate lipid-poor adrenal adenomas from hepatocellular carcinoma metastases.Abdominal radiology (New York) · 2024Article
- Article
- Inter-method agreement between wash-in and wash-out computed tomography for characterizing hyperattenuating adrenal lesions as adenomas or non-adenomas.European radiology · 2023Article
- Two nomograms based on radiomics models using triphasic CT for differentiation of adrenal lipid-poor benign lesions and metastases in a cancer population: an exploratory study.European radiology · 2023Article
- Small hyperattenuating adrenal nodules in patients with lung cancer: Differentiation of metastases from adenomas on biphasic contrast-enhanced computed tomography.Frontiers in oncology · 2023Article
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Abstract
objectivesTo investigate usefulness of biphasic computed tomography (CT) in characterizing hyperattenuating adrenal lesions in lung cancer.
methodsThis retrospective study included 239 patients with lung cancer who underwent adrenal CT for hyperattenuating (> 10 Hounsfield unit) adrenal lesions. Adrenal CT comprised unenhanced and 1-min and 15-min enhanced images. We dichotomized adrenal lesions depending on benign or metastatic lesions. Reference standard for benignity was histologic confirmation or ≥ 6-month stability on follow-up CT. Two independent readers analyzed absolute (APW) or relative percentage wash-out (RPW) using triphasic CT, and enhancement ratio (ER) or percentage wash-in (PWI) using biphasic CT (i.e., unenhanced and 1-min enhanced CT). Criteria for benignity were as follows: criteria 1, (a) APW ≥ 60% or (b) RPW ≥ 40%, and criteria 2, (a) ER > 3 and (b) PWI > 200%. We analyzed area under the curve (AUC) and accuracy for benignity, and inter-reader agreement.
resultsProportion of benign adrenal lesion was 71.1% (170/239). For criteria 1 and 2, AUCs were 0.872 (95% confidence interval [CI], 0.822-0.911) and 0.886 (95% CI, 0.838-0.923), respectively, for reader 1 (p = 0.566) and 0.816 (95% CI, 0.761-0.863) and 0.814 (95% CI, 0.759-0.862), respectively, for reader 2 (p = 0.955), and accuracies were 87.9% (210/239) and 86.2% (206/239), respectively, for reader 1 (p = 0.479) and 81.2% (194/239) and 80.3% (192/239), respectively, for reader 2 (p = 0.763). Weighted kappa was 0.725 (95% CI, 0.634-0.816) for criteria 1 and 0.736 (95% CI, 0.649-0.824) for criteria 2.
conclusionBiphasic CT can reliably characterize hyperattenuating adrenal lesions in patients with lung cancer. KEY POINTS: • Criteria from biphasic computed tomography (CT) for diagnosing benign adrenal lesions were enhancement ratio of > 3 and percentage wash-in of > 200%. • In the analysis by two independent readers, area under the curve between criteria 1 and 2 was not significantly different (0.872 and 0.886 for reader 1; 0.816 and 0.814, for reader 2; p > 0.05 for each comparison). • Wash-in characteristics from biphasic CT are helpful to predict benign adrenal lesions in lung cancer.
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