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Int Urol Nephrol. 2012 Oct;44(5):1397-402. doi: 10.1007/s11255-012-0202-4. Epub 2012 Jul 14.

The washout rate on the delayed CT image as a diagnostic tool for adrenal adenoma verified by pathology: a multicenter study.

Author information

1
Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea. psw-ooz@hanmail.net

Abstract

OBJECTIVES:

To establish the undisputed the value of washout rate for adrenal adenoma using delayed enhanced CT, we evaluated diagnostic performance of cut-off value and delayed time of washout rate by final pathologic diagnosis in a multicenter study.

METHODS:

We reviewed the pathologic and clinical records of 244 patients underwent adrenalectomies at 5 university hospitals between 2005 and 2009. We calculated the mean Housfield units (HU) of adrenal lesion at non-enhancing CT, and early and delayed enhanced CT using the region of interest. We used ROC curves to determine the specificity and sensitivity of non-enhanced CT scans and the washout rate according to the various cut-off for adrenal adenomas.

RESULTS:

We divided the patients into adrenal adenoma group (n = 138) and non-adrenal adenoma group (n = 106) based on final pathologic report. Using the unenhanced images with a threshold of 10 HU, the sensitivity was 45.7 %, and the specificity was 97.1 %. Using the 15-min-washout rate with a threshold of 55 %, the sensitivity was 93.9 %, and the specificity was 95.8 %.

CONCLUSIONS:

Regardless of various CT machines and protocols, a washout rate of 15-min-delayed CT was most useful in the diagnosis of adrenal adenomas due to the early inflow and outflow of contrast media in the tissues of adrenal adenomas.

PMID:
22798018
DOI:
10.1007/s11255-012-0202-4
[Indexed for MEDLINE]

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