Differentiating between adrenocortical carcinoma and lipid-poor cortical adenoma: A novel cross-sectional imaging-based score

Yalon, Tal; Yalon, Mariana; Assaf, Dan; Lenartowicz, Karina A.; Foster, Trenton R.; Lyden, Melanie L.; Dy, Benzon M.; Bancos, Irina; McKenzie, Travis J.

doi:10.1016/j.surg.2022.07.029

Cited by 6 publications

(4 citation statements)

References 23 publications

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“…Subclinical CPA is the most common functional adrenal tumors ( 7 ), while as many as 30% of APA patients manifest the similar clinical symptoms as CPA because of hypokalemia ( 8 , 9 ); which makes it particularly difficult to distinguish between the two from a clinical perspective. Furthermore, 10–20% of ACAs occur bilaterally or with multiple lesions ( 3 , 10 ), functional diagnosis is challenging when the responsible lesion needs to be accurately located ( 3 , 8 , 11 ). Percutaneous cannulation of the adrenal vein is the “gold standard” for APA diagnosis, but the difficulty, cost and invasiveness of the procedure limit its widespread use in clinical practice ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Quantitative energy spectrum CT in differential diagnosis of aldosterone-producing adenoma and cortisol-producing adenoma

Chen¹,

Zhang²,

Shi³

et al. 2023

Quant Imaging Med Surg

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Background Patients with aldosterone-producing adenoma (APA) and cortisol-producing adenoma (CPA) show some similar clinical symptoms, and a large overlap of conventional imaging manifestations, which make the differentiation difficult. The purpose of our study was to explore the value of gemstone spectral imaging (GSI) dual-energy computed tomography (DECT) in differential diagnosis of APA and CPA, screen out meaningful energy spectral indicators and provide theoretical basis for the differential diagnosis of the two. Methods We retrospectively analyzed the imaging and clinical data of 30 patients with APA and 27 patients with CPA who underwent GSI DECT in The First Affiliated Hospital of Zhengzhou University (a tertiary care institution). Patients were consecutively enrolled in this study, and the quantitative DECT parameters were compared between the APA and CPA groups by two-sample test. The diagnostic efficacies were evaluated by receiver operating characteristic (ROC) analysis. Results DECT parameters including CT (computed tomography) values at 40–70 keV in the arterial phase, concentrations of I (H 2 O) and fat (I) in the arterial phase, and the effective atomic number in the venous phase, were significantly different between the APA and CPA groups (all P<0.001), and the area under the curve (AUC) values are 0.80, 0.79, 0.88, 0.76, 0.82, 0.87, and 0.86. Conclusions DECT quantitative parameters can effectively identify APA and CPA, the CT values at 40 and 60 keV in the arterial phase, the normalized CT value at 60 keV, the I (H 2 O), fat (I) concentration in the arterial phase and the effective atomic number parameter in the venous phase had valuable diagnostic performance.

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Section: Discussionmentioning

confidence: 99%

Quantitative energy spectrum CT in differential diagnosis of aldosterone-producing adenoma and cortisol-producing adenoma

Chen¹,

Zhang²,

Shi³

et al. 2023

Quant Imaging Med Surg

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“…The score is built on differences between the groups in nine parameters: size, attenuation, thin and thick rim enhancement patterns, heterogeneity, calcification, necrosis, fat infiltration, and lymph node prominence. The score had 100 per cent sensitivity for the exclusion of ACC, 80 per cent specificity, 66 per cent positive predictive value (PPV), and 100 per cent negative predictive value (NPV,) with an area under the curve of 0.974 12 . The utility of this score should be confirmed in future studies.…”

Section: Adrenocortical Cancermentioning

confidence: 99%

Surgery for advanced adrenal malignant disease: recommendations based on European Society of Endocrine Surgeons consensus meeting

Mihai,

De Crea,

Guerin

et al. 2024

British Journal of Surgery

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“…Perifériás septalis kontraszthalmozás esetén 5 pont, kalcifikáció esetén 4 pont adható. Ha egy mellékvesetumor összesített pontszáma ebben a rendszerben kisebb, mint 3, az 100%-os érzékenységgel jelzi, hogy a tumor benignus, a malignitásra vonatkozó negatív prediktív érték 100% [12].…”

Section: A Mellékvesekéreg-carcinoma Radiológiai Megjelenéseunclassified

A mellékvesekéreg-carcinoma diagnosztikája

Tőke,

Tóth

2024

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A mellékvesekéreg-carcinoma ritka, rossz prognózisú megbetegedés. Az érintett betegek kórjóslatát döntően meghatározza, hogy a betegség korán, még lokoregionális stádiumban kerüljön felismerésre, amikor a sebészi tumoreltávolítással jelentősen növelhető a gyógyulás esélye. A mellékvese-daganatok dignitásának meghatározása gyakran jelent kihívást a preoperatív kivizsgálás során, a diagnózisalkotást hagyományos radiológiai és laboratóriumi vizsgálatok segítik. Újabban igen jó diagnosztikai pontosságot mutató biomarkerek is megismerésre kerültek, klinikai használatuk a közeljövőben várható. Közülük is kiemelkednek a gáz-, illetve folyadékkromatográfián alapuló szteroidmetabolomikai vizsgálatok, valamint a miRNS-ek vizsgálata. Ebben az összefoglalóban bemutatjuk a mellékvesekéreg-carcinoma azonosítását segítő preoperatív klinikai és posztoperatív patológiai vizsgálómódszereket. Orv Hetil. 2024; 165(4): 123–131.

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Differentiating between adrenocortical carcinoma and lipid-poor cortical adenoma: A novel cross-sectional imaging-based score

Cited by 6 publications

References 23 publications

Quantitative energy spectrum CT in differential diagnosis of aldosterone-producing adenoma and cortisol-producing adenoma

Quantitative energy spectrum CT in differential diagnosis of aldosterone-producing adenoma and cortisol-producing adenoma

Surgery for advanced adrenal malignant disease: recommendations based on European Society of Endocrine Surgeons consensus meeting

A mellékvesekéreg-carcinoma diagnosztikája

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