Diagnostic value of combined versus individual MRI parameters in distinguishing adenomatous from non-adenomatous adrenal lesions in cancer patients

Purpose: Our aim was to evaluate the diagnostic value of MRI using different parameters in differentiation of adenomas versus non-adenomas adrenal lesions. Materials and methods: Forty-five patients with 48 adrenal masses (28 lipid rich adenomas, 3 lipid poor adenomas, 15 metastases and 2 lymphoma)...

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Main Authors: Sally Emad-Eldin, Mona El-Kalioubie
Format: Article
Language:English
Published: SpringerOpen 2014-09-01
Series:The Egyptian Journal of Radiology and Nuclear Medicine
Subjects:
MR
Online Access:http://www.sciencedirect.com/science/article/pii/S0378603X1400117X
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spelling doaj-2647668fe5894c9c90d041e9598d60b72020-11-25T02:21:23ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine0378-603X2014-09-0145392994110.1016/j.ejrnm.2014.06.004Diagnostic value of combined versus individual MRI parameters in distinguishing adenomatous from non-adenomatous adrenal lesions in cancer patientsSally Emad-EldinMona El-KalioubiePurpose: Our aim was to evaluate the diagnostic value of MRI using different parameters in differentiation of adenomas versus non-adenomas adrenal lesions. Materials and methods: Forty-five patients with 48 adrenal masses (28 lipid rich adenomas, 3 lipid poor adenomas, 15 metastases and 2 lymphoma) were retrospectively evaluated with MRI. The mean diameter of adrenal mass, T2WI signal, signal drop on chemical shift imaging (CSI) and enhancement pattern were assessed separately and in various combinations. Accuracies, sensitivities, specificities, PPV, NPV and P values by Chi-square test were calculated for individual and combined parameters. Results: Signal drop on CSI and enhancement pattern were the most statistically significant diagnostic discriminators of adenomatous and non-adenomatous lesions with accuracies, specificities and sensitivities of 93.8%, 90.3%, 100% and 91.7%, 93.5%, 88.2%, respectively (P-value <0.0001). The best performance of a combination of parameters was obtained after exclusion of the size, with an accuracy of 89.6% (P-value <0.0001). Conclusion: The most specific predictors for adrenal mass characterization were CSI signal drop and Gd-DTPA enhancement characteristics. Combining the MR parameters did not prove superior to those two individual parameters, however it yielded a valuable diagnostic protocol for distinguishing the adrenal masses, considering that size criterion should not be used as an individual discriminator.http://www.sciencedirect.com/science/article/pii/S0378603X1400117XMRAdrenal glandAdenomaNon-adenomatous
collection DOAJ
language English
format Article
sources DOAJ
author Sally Emad-Eldin
Mona El-Kalioubie
spellingShingle Sally Emad-Eldin
Mona El-Kalioubie
Diagnostic value of combined versus individual MRI parameters in distinguishing adenomatous from non-adenomatous adrenal lesions in cancer patients
The Egyptian Journal of Radiology and Nuclear Medicine
MR
Adrenal gland
Adenoma
Non-adenomatous
author_facet Sally Emad-Eldin
Mona El-Kalioubie
author_sort Sally Emad-Eldin
title Diagnostic value of combined versus individual MRI parameters in distinguishing adenomatous from non-adenomatous adrenal lesions in cancer patients
title_short Diagnostic value of combined versus individual MRI parameters in distinguishing adenomatous from non-adenomatous adrenal lesions in cancer patients
title_full Diagnostic value of combined versus individual MRI parameters in distinguishing adenomatous from non-adenomatous adrenal lesions in cancer patients
title_fullStr Diagnostic value of combined versus individual MRI parameters in distinguishing adenomatous from non-adenomatous adrenal lesions in cancer patients
title_full_unstemmed Diagnostic value of combined versus individual MRI parameters in distinguishing adenomatous from non-adenomatous adrenal lesions in cancer patients
title_sort diagnostic value of combined versus individual mri parameters in distinguishing adenomatous from non-adenomatous adrenal lesions in cancer patients
publisher SpringerOpen
series The Egyptian Journal of Radiology and Nuclear Medicine
issn 0378-603X
publishDate 2014-09-01
description Purpose: Our aim was to evaluate the diagnostic value of MRI using different parameters in differentiation of adenomas versus non-adenomas adrenal lesions. Materials and methods: Forty-five patients with 48 adrenal masses (28 lipid rich adenomas, 3 lipid poor adenomas, 15 metastases and 2 lymphoma) were retrospectively evaluated with MRI. The mean diameter of adrenal mass, T2WI signal, signal drop on chemical shift imaging (CSI) and enhancement pattern were assessed separately and in various combinations. Accuracies, sensitivities, specificities, PPV, NPV and P values by Chi-square test were calculated for individual and combined parameters. Results: Signal drop on CSI and enhancement pattern were the most statistically significant diagnostic discriminators of adenomatous and non-adenomatous lesions with accuracies, specificities and sensitivities of 93.8%, 90.3%, 100% and 91.7%, 93.5%, 88.2%, respectively (P-value <0.0001). The best performance of a combination of parameters was obtained after exclusion of the size, with an accuracy of 89.6% (P-value <0.0001). Conclusion: The most specific predictors for adrenal mass characterization were CSI signal drop and Gd-DTPA enhancement characteristics. Combining the MR parameters did not prove superior to those two individual parameters, however it yielded a valuable diagnostic protocol for distinguishing the adrenal masses, considering that size criterion should not be used as an individual discriminator.
topic MR
Adrenal gland
Adenoma
Non-adenomatous
url http://www.sciencedirect.com/science/article/pii/S0378603X1400117X
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AT monaelkalioubie diagnosticvalueofcombinedversusindividualmriparametersindistinguishingadenomatousfromnonadenomatousadrenallesionsincancerpatients
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