Differentiation between adrenal adenomas and nonadenomas using dynamic contrast-enhanced computed tomography

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• Adrenal masses require accurate characterization to guide clinical management.
• Distinguishing between adrenal adenomas and nonadenomas is crucial for appropriate treatment.
• Dynamic contrast-enhanced computed tomography (DCE-CT) offers functional information for tissue characterization.

Purpose of the Study:

• To evaluate the diagnostic performance of DCE-CT parameters in differentiating adrenal adenomas from nonadenomas.
• To assess the utility of time density (TD) curves and enhancement washout percentages in adrenal mass characterization.

Main Methods:

• Retrospective analysis of DCE-CT data from 70 patients with 79 histopathologically confirmed adrenal masses.
• Classification of TD curves into 5 types and analysis of relative (Washr) and absolute (Washa) enhancement washout percentages.
• Correlation of imaging findings with histopathological diagnoses of adenomas and nonadenomas.

Main Results:

• TD curve types showed significant differences between adenomas (Types A, C) and nonadenomas (Types B, D, E).
• TD curves achieved 93% sensitivity, 80% specificity, and 87% accuracy for adenoma diagnosis.
• Washr and Washa values were higher in adenomas than nonadenomas, with optimal diagnostic efficiency at 7-min delay time.
• Using Washr ≥34% or Washa ≥43% yielded 84% sensitivity, 77% specificity, and 81% accuracy for adenoma detection.

Conclusions:

• DCE-CT, particularly TD curves and enhancement washout analysis, is valuable for characterizing adrenal tumors.
• This technique is especially useful for differentiating lipid-poor adenomas, improving diagnostic accuracy.
• Combined analysis of TD curves and washout parameters enhances the reliable categorization of adrenal masses.