Erschienen in:
01.07.2014 | Computed Tomography
Can single-phase dual-energy CT reliably identify adrenal adenomas?
verfasst von:
A. Helck, N. Hummel, F. G. Meinel, T. Johnson, K. Nikolaou, A. Graser
Erschienen in:
European Radiology
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Ausgabe 7/2014
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Abstract
Purpose
To evaluate whether single-phase dual-energy-CT-based attenuation measurements can reliably differentiate lipid-rich adrenal adenomas from malignant adrenal lesions.
Materials and methods
We retrospectively identified 51 patients with adrenal masses who had undergone contrast-enhanced dual-energy-CT (140/100 or 140/80 kVp). Virtual non-contrast and colour-coded iodine images were generated, allowing for measurement of pre- and post-contrast density on a single-phase acquisition. Adrenal adenoma was diagnosed if density on virtual non-contrast images was ≤10 HU. Clinical follow-up, true non-contrast CT, PET/CT, in- and opposed-phase MRI, and histopathology served as the standard of reference.
Results
Based on the standard of reference, 46/57 (80.7 %) adrenal masses were characterised as adenomas or other benign lesions; 9 malignant lesions were detected. Based on a cutoff value of 10 HU, virtual non-contrast images allowed for correct identification of adrenal adenomas in 33 of 46 (71 %), whereas 13/46 (28 %) adrenal adenomas were lipid poor with a density ≥10 HU. Based on the threshold of 10 HU on the virtual non-contrast images, the sensitivity, specificity, and accuracy for detection of benign adrenal lesions was 73 %, 100 %, and 81 % respectively.
Conclusion
Virtual non-contrast images derived from dual-energy-CT allow for accurate characterisation of lipid-rich adrenal adenomas and can help to avoid additional follow-up imaging.
Key Points
• Adrenal adenomas are a common lesion of the adrenal glands.
• Differentiation of benign adrenal adenomas from malignant adrenal lesions is important.
• Dual-energy based virtual non-contrast images help to evaluate patients with adrenal adenomas.