To report hounsfeld units or not: There is no question

Area of Science:

• Radiology
• Endocrinology
• Oncology

Background:

• Adrenal incidentalomas are frequently discovered but often inadequately evaluated.
• Radiology report summaries and recommendations can improve the diagnostic pathway.
• The impact of reporting Hounsfield units (HU) on adrenal incidentaloma follow-up requires further investigation.

Purpose of the Study:

• To evaluate the effect of reporting Hounsfield units (HU) on the follow-up and evaluation of adrenal incidentalomas.
• To determine if reporting HU in radiology reports influences outpatient referral, biochemical evaluation, and dedicated imaging.

Main Methods:

• A retrospective study of patients with adrenal incidentalomas identified on noncontrast CT scans (2015-2020).
• Chart review to compare patient and imaging characteristics between those with and without reported HU.
• Multivariate analysis to assess the impact of HU, summary reporting, and recommendations on patient outcomes.

Main Results:

• Out of 363 patients, HU were reported in 36 (9.9%).
• Reporting HU alongside summary findings and recommendations increased outpatient referral likelihood 10.1 to 32.6-fold (p < 0.001).
• The likelihood of biochemical workup increased 2.5 to 7.8-fold (p < 0.001).

Conclusions:

• Reporting adrenal incidentaloma Hounsfield units on noncontrast CT scans is associated with improved evaluation rates.
• This practice significantly increases the likelihood of outpatient referral and biochemical workup for adrenal incidentalomas.
• Standardizing HU reporting in radiology can enhance the management of adrenal incidentalomas.