Virtual non-contrast detector-based spectral CT predictably overestimates tissue density for the characterisation of adrenal lesions compared to true non-contrast CT.
Adenoma
Adrenal glands
Dual-energy CT
Virtual unenhanced images
Journal
Abdominal radiology (New York)
ISSN: 2366-0058
Titre abrégé: Abdom Radiol (NY)
Pays: United States
ID NLM: 101674571
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
received:
31
01
2022
accepted:
11
04
2022
revised:
08
04
2022
pubmed:
14
5
2022
medline:
28
6
2022
entrez:
13
5
2022
Statut:
ppublish
Résumé
To establish if virtual non-contrast (VNC) images generated from contrast-enhanced detector-based spectral CT could replace true non-contrast (TNC) imaging for the characterisation of adrenal masses. TNC and VNC images were retrospectively reviewed for 39 patients with one or more adrenal lesions who underwent contrast-enhanced spectral CT of the upper abdomen. Lesions were categorised as either 'adenoma' or 'indeterminate/other lesion' based on current reference standards. The CT density of each lesion was measured on both image sets by two readers and compared using Wilcoxon signed-rank test. ROC analysis with Youden's J index method was performed to determine the optimal attenuation cut-off for diagnosing benign adenoma on VNC images. Forty-four lesions were included, 37 of which were diagnosed as adenomas. There were significant differences between TNC and VNC measurements for both readers (mean difference 9.1 HU for reader 1; 9.8 HU for reader 2; p < 0.01). Optimal attenuation thresholds for diagnosing adenomas on VNC were 25.3 HU (reader 1) and 23.9 HU (reader 2) for the entire population, and 18.3 HU (reader 1) and 19.7 HU (reader 2) for lipid-rich adenomas < 10 HU on TNC imaging. There is insufficient evidence to support the use of VNC as a substitute for TNC images in the characterisation of adrenal lesions. VNC using a detector-based spectral CT scanner shows a predictable increase in attenuation values compared to TNC. Thus, future studies might be better directed towards finding a new threshold value for diagnosing benign adrenal adenomas on VNC imaging.
Identifiants
pubmed: 35562563
doi: 10.1007/s00261-022-03528-y
pii: 10.1007/s00261-022-03528-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2462-2467Informations de copyright
© 2022. Crown.
Références
Bovio S, Cataldi A, Reimondo G, Sperone P, Novello S, Berruti A, et al. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest. 2006;29(4):298-302.
doi: 10.1007/BF03344099
Maher DI, Williams E, Grodski S, Serpell JW, Lee JC. Adrenal incidentaloma follow-up is influenced by patient, radiologic, and medical provider factors: A review of 804 cases. Surgery. 2018 Dec;164(6):1360-1365. doi: https://doi.org/10.1016/j.surg.2018.07.011 . Epub 2018 Aug 28. PMID: 30170818.
doi: 10.1016/j.surg.2018.07.011
pubmed: 30170818
Song JH, Chaudhry FS, Mayo-Smith WW. The incidental adrenal mass on CT: prevalence of adrenal disease in 1,049 consecutive adrenal masses in patients with no known malignancy. AJR Am J Roentgenol. 2008 May;190(5):1163-8. doi: https://doi.org/10.2214/AJR.07.2799 . PMID: 18430826.
doi: 10.2214/AJR.07.2799
pubmed: 18430826
Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2016;175(2):G1-G34.
doi: 10.1530/EJE-16-0467
Nagayama Y, Inoue T, Oda S, Tanoue S, Nakaura T, Ikeda O, et al. Adrenal Adenomas versus Metastases: Diagnostic Performance of Dual-Energy Spectral CT Virtual Noncontrast Imaging and Iodine Maps. Radiology. 2020;296(2):324-32.
doi: 10.1148/radiol.2020192227
Slebocki K, Kraus B, Chang DH, Hellmich M, Maintz D, Bangard C. Incidental Findings in Abdominal Dual-Energy Computed Tomography: Correlation Between True Noncontrast and Virtual Noncontrast Images Considering Renal and Liver Cysts and Adrenal Masses. J Comput Assist Tomogr. 2017;41(2):294-7.
doi: 10.1097/RCT.0000000000000503
Botsikas D, Triponez F, Boudabbous S, Hansen C, Becker CD, Montet X. Incidental adrenal lesions detected on enhanced abdominal dual-energy CT: can the diagnostic workup be shortened by the implementation of virtual unenhanced images? Eur J Radiol. 2014;83(10):1746-51.
doi: 10.1016/j.ejrad.2014.06.017
Gnannt R, Fischer M, Goetti R, Karlo C, Leschka S, Alkadhi H. Dual-energy CT for characterization of the incidental adrenal mass: preliminary observations. AJR Am J Roentgenol. 2012 Jan;198(1):138-44.
doi: 10.2214/AJR.11.6957
Cao J, Lennartz S, Parakh A, Joseph E, Blake M, Sahani D, et al. Dual-layer dual-energy CT for characterization of adrenal nodules: can virtual unenhanced images replace true unenhanced acquisitions? Abdom Radiol (NY). 2021;46(9):4345-52.
doi: 10.1007/s00261-021-03062-3
Ho LM, Marin D, Neville AM, Barnhart HX, Gupta RT, Paulson EK, et al. Characterization of adrenal nodules with dual-energy CT: can virtual unenhanced attenuation values replace true unenhanced attenuation values? AJR Am J Roentgenol. 2012;198(4):840-5.
doi: 10.2214/AJR.11.7316
Glazer DI, Maturen KE, Kaza RK, Francis IR, Keshavarzi NR, Parker RA, et al. Adrenal Incidentaloma triage with single-source (fast-kilovoltage switch) dual-energy CT. AJR Am J Roentgenol. 2014;203(2):329-35.
doi: 10.2214/AJR.13.11811
Jacobsen MC, Schellingerhout D, Wood CA, Tamm EP, Godoy MC, Sun J, Cody DD. Intermanufacturer Comparison of Dual-Energy CT Iodine Quantification and Monochromatic Attenuation: A Phantom Study. Radiology. 2018 Apr;287(1):224-234.
doi: 10.1148/radiol.2017170896
R Core Team (2021). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/ .
Connolly MJ, McInnes MDF, El-Khodary M, McGrath TA, Schieda N. Diagnostic accuracy of virtual non-contrast enhanced dual-energy CT for diagnosis of adrenal adenoma: A systematic review and meta-analysis. Eur Radiol. 2017;27(10):4324-35.
doi: 10.1007/s00330-017-4785-0
Ananthakrishnan L, Rajiah P, Ahn R, Rassouli N, Xi Y, Soesbe TC, Lewis MA, Lenkinski RE, Leyendecker JR, Abbara S. Spectral detector CT-derived virtual non-contrast images: comparison of attenuation values with unenhanced CT. Abdom Radiol (NY). 2017 Mar;42(3):702-709. doi: https://doi.org/10.1007/s00261-016-1036-9 . PMID: 28084546.
doi: 10.1007/s00261-016-1036-9
pubmed: 28084546
Sauter AP, Muenzel D, Dangelmaier J, Braren R, Pfeiffer F, Rummeny EJ, Noël PB, Fingerle AA. Dual-layer spectral computed tomography: Virtual non-contrast in comparison to true non-contrast images. Eur J Radiol. 2018 Jul;104:108-114. doi: https://doi.org/10.1016/j.ejrad.2018.05.007 . Epub 2018 May 10. PMID: 29857855.
doi: 10.1016/j.ejrad.2018.05.007
pubmed: 29857855