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Can Assoc Radiol J. 2014 Feb;65(1):86-90. doi: 10.1016/j.carj.2012.12.006. Epub 2013 May 22.

Morphologic change in computed tomography of aldosterone-producing adenoma after radiofrequency ablation.

Author information

  • 1Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong/Chinese University of Hong Kong, Hong Kong. Electronic address: leekalok2909@yahoo.com.hk.
  • 2Department of Surgery, Prince of Wales Hospital, Hong Kong.
  • 3Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong/Chinese University of Hong Kong, Hong Kong.
  • 4Department of Radiology, North District Hospital, Hong Kong.

Abstract

OBJECTIVE:

To evaluate the morphologic changes of aldosterone-producing adenoma (APA) on computed tomography (CT) before and after radiofrequency ablation (RFA) and to assess the factors that are important in determining successful complete ablation of these tumours.

METHOD:

Between August 2004 and August 2011, 24 consecutive patients with APA undergoing CT-guided percutaneous RFA were identified from our prospective database. The pre-RFA and post-RFA CT appearances of these APAs that showed positive biochemical response were reviewed retrospectively for their 3-dimensional size, tumour volume, and CT attenuation in terms of Hounsfield units (HU). A comparison of these parameters before and after RFA was performed.

RESULTS:

In this study, there were 23 APAs in these 24 patients that showed biochemical cure of primary aldosteronism after RFA. When comparing post-RFA to pre-RFA CTs, there was no significant change in tumour size (14.5 mm vs 14.6 mm: P = .83) and tumour volume (1.55 cm(3) vs 1.59 cm(3); P = .41) after RFA. In nonenhanced CT images, there was no significant reduction in HU from pre-RFA to post-RFA measurements (4.4 HU vs 7.9 HU; P = .52). In contrast-enhanced CTs, there was a significant drop in HU after RFA (from 48.3 HU to 14.7 HU; P = .03). None of the included cases showed a focal region of contrast enhancement to suggest residual tumour.

CONCLUSION:

A change in tumour size, tumour volume, and HU in nonenhanced CT were unreliable in defining radiologic treatment success. Only changes in HU in contrast-enhanced CT was useful in confirming a positive treatment response after RFA for APA.

Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Adrenal adenoma; Computed tomography; Radiofrequency ablation

PMID:
23706869
[PubMed - indexed for MEDLINE]
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