The role of apparent diffusion coefficient values in differentiation between adrenal masses

Çiçekçi, Mehtap; Onur, Mehmet Ruhi; Aydin, Ayşe; Gül, Yeliz; Özkan, Yusuf; Akpolat, Nusret; Kocakoç, Ercan

doi:10.1016/j.clinimag.2013.11.003

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…Although several studies have compared ADC of adrenal tumors, the results have been controversial, with most studies being unable to find significant differences in ADC values between benign and malignant adrenal tumors or among the histological subtypes . In our study, the mean ADC values calculated with any b‐value combination showed no significant difference between adrenal adenomas and pheochromocytomas, as reported in previous studies .…”

Section: Discussionsupporting

confidence: 62%

“…We used size stability during a 6‐month or longer follow‐up to confirm adrenal adenomas. In several previous studies, this has been an accepted criterion for classifying a lesion as benign . Third, the choice of b‐value plays an important role for the ADC value, because ADC represents perfusion as well as molecular diffusion .…”

Section: Discussionmentioning

confidence: 99%

“…Among them, 64 patients were diagnosed with adrenal adenoma or pheochromocytoma, as identified through a review of clinical charts with the radiology information system, and records of the Department of Human Pathology. Adrenal adenomas were diagnosed by pathology or based on stability for at least 6 months of follow‐up CT studies . Seventeen patients with adrenal adenomas were excluded due to tumor size that was very small (<10 mm) for evaluation and may affect the ADC values on DW imaging …”

Section: Methodsmentioning

confidence: 99%

“…Through the measurement of apparent diffusion coefficient (ADC), DW MRI provides qualitative and quantitative information that is pertinent to tissue structure. However, there are limited studies on the characterization of adrenal lesions using DW MRI . In particular, the ability of ADC values in differentiating adrenal adenomas from pheochromocytomas has been controversial …”

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confidence: 99%

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ADC histogram analysis for adrenal tumor histogram analysis of apparent diffusion coefficient in differentiating adrenal adenoma from pheochromocytoma

Umanodan

Fukukura

Kumagae

et al. 2016

Magnetic Resonance Imaging

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Purpose: To determine the diagnostic performance of apparent diffusion coefficient (ADC) histogram analysis in diffusionweighted (DW) magnetic resonance imaging (MRI) for differentiating adrenal adenoma from pheochromocytoma. Materials and Methods: We retrospectively evaluated 52 adrenal tumors (39 adenomas and 13 pheochromocytomas) in 47 patients (21 men, 26 women; mean age, 59.3 years; range, 16-86 years) who underwent DW 3.0T MRI. Histogram parameters of ADC (b-values of 0 and 200 [ADC 200 ], 0 and 400 [ADC 400 ], and 0 and 800 s/mm 2 [ADC 800 ])-mean, variance, coefficient of variation (CV), kurtosis, skewness, and entropy-were compared between adrenal adenomas and pheochromocytomas, using the Mann-Whitney U-test. Receiver operating characteristic (ROC) curves for the histogram parameters were generated to differentiate adrenal adenomas from pheochromocytomas. Sensitivity and specificity were calculated by using a threshold criterion that would maximize the average of sensitivity and specificity. Results: Variance and CV of ADC 800 were significantly higher in pheochromocytomas than in adrenal adenomas (P < 0.001 and P 5 0.001, respectively). With all b-value combinations, the entropy of ADC was significantly higher in pheochromocytomas than in adrenal adenomas (all P 0.001), and showed the highest area under the ROC curve among the ADC histogram parameters for diagnosing adrenal adenomas (ADC 200 , 0.82; ADC 400 , 0.87; and ADC 800 , 0.92), with sensitivity of 84.6% and specificity of 84.6% (cutoff, 2.82) with ADC 200 ; sensitivity of 89.7% and specificity of 84.6% (cutoff, 2.77) with ADC 400 ; and sensitivity of 94.9% and specificity of 92.3% (cutoff, 2.67) with ADC 800 . Conclusion: ADC histogram analysis of DW MRI can help differentiate adrenal adenoma from pheochromocytoma. Level of Evidence: 3

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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ADC histogram analysis for adrenal tumor histogram analysis of apparent diffusion coefficient in differentiating adrenal adenoma from pheochromocytoma

Umanodan

Fukukura

Kumagae

et al. 2016

Magnetic Resonance Imaging

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“…Other rare adrenal lesions especially with tumor appearance are myelolipoma, neurofibroma, hamartoma, xanthomatosis, amyloidosis, granulomatosis [ 17 , 18 , 19 ]. The adrenal bed may locate masses of non-adrenal origin, like those arising from the pancreas, spleen or kidney and rarely imagery artefacts need to be differentiated [ 20 , 21 , 22 ]. Knowing this large panel of potential diagnosis related to an adrenal lesion, the cysts of this gland are rare conditions which may be recognized at any age, following the scenario of an incidentaloma or severe general disturbances [ 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Cystic adrenal lesions: focus on pediatric population (a review)

Cârșote

Ghemigian

Terzea

et al. 2017

Medicine and Pharmacy Reports

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Background and aimThe cysts may potentially affect any organ; adrenals cysts are rare. This is a review of the literature regarding adrenal cysts, focusing on children and young adults.General dataThree major types have been described: pure cysts (endothelial, epithelial, and hemorrhagic or pseudocyst), parasitic (as hydatid) cysts and cystic part of a tumour (most frequent are neuroblastoma, ganglioneuroma, pheocromocytoma, and teratoma). The complications are: bleeding, local pressure effects; infection; rupture (including post-traumatic); arterial hypertension due to renal vessels compression. Adrenal hemorrhage represents a particular condition associating precipitating factors such as: coagulation defects as Factor IX or X deficiency, von Willebrand disease, thrombocytopenia; antiphospholipid syndrome; previous therapy with clopidogrel or corticosteroids; the rupture of a prior tumour. At birth, the most suggestive features are abdominal palpable mass, anemia, and persistent jaundice. Adrenal insufficiency may be found especially in premature delivery. The hemorrhage is mostly self-limiting. Antenatal ultrasound diagnosis of a cyst does not always predict the exact pathology result. The most important differential diagnosis of adrenal hemorrhage/hemorrhagic cyst is cystic neuroblastoma which is highly suggestive in the presence of distant metastases and abnormal catecholamine profile. The major clue to differentiate the two conditions is the fact that the tumor is stable or increases over time while the adrenal hemorrhage is expected to remit within one to two weeks.ConclusionPediatric adrenal cysts vary from simple cysts with a benign behavior to neoplasia- related lesions displaying severe prognosis as seen in cystic neuroblastoma. A multidisciplinary team is required for their management which is conservative as close follow-up or it makes necessary different surgical procedures in cases with large masses or if a malignancy suspicion is presented. Recently, laparoscopic approach is regarded as a safe procedure by some authors but generally, open surgery is more frequent used compare to adults; in most cases the preservation of normal gland is advisable.

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Renal, Adrenal, and Retroperitoneal Masses

García‐Figueiras

Baleato-González

2018

Diffusion Weighted Imaging of the Genitourinary System

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The role of apparent diffusion coefficient values in differentiation between adrenal masses

Cited by 5 publications

References 26 publications

ADC histogram analysis for adrenal tumor histogram analysis of apparent diffusion coefficient in differentiating adrenal adenoma from pheochromocytoma

ADC histogram analysis for adrenal tumor histogram analysis of apparent diffusion coefficient in differentiating adrenal adenoma from pheochromocytoma

Cystic adrenal lesions: focus on pediatric population (a review)

Renal, Adrenal, and Retroperitoneal Masses

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