Characterisation of Adrenal Masses with Contrast Enhanced Computed TomographyAdrenal Protocol: A Cross-sectional Study
Introduction: Adrenal masses are increasingly identified due to advancements in cross-sectional imaging. Radiology is critical in differentiating benign from malignant adrenal lesions, aiding in appropriate clinical management. Adrenal masses can arise from primary neoplasms, metastasis, hemorrhage,...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2025-02-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/20623/76559_CE[Ra1]_F(SHU)_QC(PS_SS)_PF1(VD_OM)_redo_PFA(IS)_PB(VD_IS)_PN(IS).pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Introduction: Adrenal masses are increasingly identified due to advancements in cross-sectional imaging. Radiology is critical in differentiating benign from malignant adrenal lesions, aiding in appropriate clinical management. Adrenal masses can arise from primary neoplasms, metastasis, hemorrhage, or hormonal stimulation, with adenomas and metastasis being the most common types. Characterising these masses is essential, as malignancy in adrenal lesions may indicate incurable primary disease, while benign lesions allow for curative treatment approaches.
Aim: To assess the accuracy of the Contrast Enhanced Computed Tomography (CECT) washout study in characterising adrenal masses as benign or malignant.
Materials and Methods: A hospital-based cross-sectional study was conducted at the Department of Radiodiagnosis, Gauhati Medical College and Hospital, Guwahati, Assam, India from August 2022 to December 2023 on 50 patients with 53 adrenal masses. Patients underwent CECT using a Philips brilliance iCT 256-slice machine. Adrenal masses with non enhanced attenuation values over 10 Hounsfield Units (HU) were evaluated through Absolute Percentage Washout (APW) and Relative Percentage Washout (RPW) criteria. APW and RPW thresholds of 60% and 40%, respectively, were used to classify masses as adenomas. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software version 21.0. Continuous variables were expressed as mean±SD, and an Independent t-test was used for comparison. Categorical variables were expressed in terms of frequency and percentage, and variables were compared using the Chi-square test. Parameters between adenomas (benign adrenal masses) and non adenomas (malignant adrenal masses) were compared, with significance set at p-value <0.05.
Results: A total of 53 adrenal masses were evaluated in 50 patients (29 males and 21 females) with a mean age of 53.02±13.98 years (range: 27-77 years). After Histopathological Examination (HPE), it was determined that 24 of the masses were adrenal adenomas, i.e., benign adrenal masses, whereas the remaining 29 masses were classified as non adenomas, i.e., malignant adrenal masses. Malignant lesions were significantly larger than benign adenomas (p-value=0.026) and showed lower APW and RPW values. Using a 60% APW threshold, the sensitivity and specificity for differentiating adenomas were 89.6% and 95.8%, respectively. The RPW method with a 40% cut-off yielded a sensitivity of 86.2% and specificity of 91.7.
Conclusion: The CECT washout studies demonstrate high accuracy in characterising adrenal masses, with APW and RPW showing robust sensitivity and specificity. |
|---|---|
| ISSN: | 2249-782X 0973-709X |