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Dual-energy multidetector CT for the characterization of incidental adrenal nodules: diagnostic performance of contrast-enhanced material density analysis.

Publication ,  Journal Article
Mileto, A; Nelson, RC; Marin, D; Roy Choudhury, K; Ho, LM
Published in: Radiology
February 2015

PURPOSE: To determine whether contrast material-enhanced dual-energy multidetector computed tomography (CT) with material decomposition analysis allows differentiation of adrenal adenomas from nonadenomatous lesions and to compare findings with those of nonenhanced multidetector CT. MATERIALS AND METHODS: This retrospective HIPAA-compliant study was approved by the institutional review board of Duke University, with waiver of informed consent. Thirty-eight nonconsecutive patients (22 men and 16 women; mean age, 65 years) with 47 adrenal nodules underwent nonenhanced and contrast-enhanced dual-energy multidetector CT of the abdomen. For each adrenal nodule, nonenhanced attenuation values were recorded; dual-energy density measurements were obtained by using fat-iodine and fat-water material density basis pairs. Mean and median values of nonenhanced attenuation and material densities were compared between adenomas and nonadenomas by using the two-sample t test and Wilcoxon rank sum test, respectively. The diagnostic performance of nonenhanced multidetector CT and dual-energy material densities was assessed by setting the specificity for diagnosis of adenomas at 100%. RESULTS: Adenomas (lipid rich and lipid poor) displayed significantly different mean density values (in milligrams per cubic centimeter) than those of nonadenomas on fat-iodine (970.4 ± 17.2 vs 1012.3 ± 9.3), iodine-fat (2.5 ± 0.3 vs 4.5 ± 1.5), fat-water (-666.7 ± 154.8 vs -2141.8 ± 953.2), and water-fat (1628.4 ± 177.3 vs 3225 ± 986.1) images, respectively (P < .0001). For diagnosis of adenomas, dual-energy material density analysis showed a sensitivity of 96% (23 of 24 lesions) at a specificity of 100% (23 of 23 lesions), yielding significantly improved diagnostic performance compared with nonenhanced multidetector CT attenuation (sensitivity of 67% [16 of 24 lesions] at a specificity of 100% [23 of 23 lesions]) (P = .035). CONCLUSION: Contrast-enhanced dual-energy multidetector CT with material density analysis allows differentiation between adrenal adenomas and nonadenomas, reflecting an improved ability over nonenhanced multidetector CT for diagnosis of lipid-poor adenoma.

Duke Scholars

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

February 2015

Volume

274

Issue

2

Start / End Page

445 / 454

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Retrospective Studies
  • Nuclear Medicine & Medical Imaging
  • Multidetector Computed Tomography
  • Male
  • Incidental Findings
  • Humans
  • Female
  • Contrast Media
  • Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mileto, A., Nelson, R. C., Marin, D., Roy Choudhury, K., & Ho, L. M. (2015). Dual-energy multidetector CT for the characterization of incidental adrenal nodules: diagnostic performance of contrast-enhanced material density analysis. Radiology, 274(2), 445–454. https://doi.org/10.1148/radiol.14140876
Mileto, Achille, Rendon C. Nelson, Daniele Marin, Kingshuk Roy Choudhury, and Lisa M. Ho. “Dual-energy multidetector CT for the characterization of incidental adrenal nodules: diagnostic performance of contrast-enhanced material density analysis.Radiology 274, no. 2 (February 2015): 445–54. https://doi.org/10.1148/radiol.14140876.
Mileto, Achille, et al. “Dual-energy multidetector CT for the characterization of incidental adrenal nodules: diagnostic performance of contrast-enhanced material density analysis.Radiology, vol. 274, no. 2, Feb. 2015, pp. 445–54. Pubmed, doi:10.1148/radiol.14140876.

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

February 2015

Volume

274

Issue

2

Start / End Page

445 / 454

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Retrospective Studies
  • Nuclear Medicine & Medical Imaging
  • Multidetector Computed Tomography
  • Male
  • Incidental Findings
  • Humans
  • Female
  • Contrast Media
  • Aged