Comparison of CT histogram analysis and chemical shift MRI in the characterization of indeterminate adrenal nodules.

2.50
Hdl Handle:
http://hdl.handle.net/10541/72548
Title:
Comparison of CT histogram analysis and chemical shift MRI in the characterization of indeterminate adrenal nodules.
Authors:
Jhaveri, Kartik S; Wong, Fenella; Ghai, Sangeet; Haider, Masoom A
Abstract:
OBJECTIVE: Adrenal nodules having an attenuation of more than 10 H on unenhanced CT are considered indeterminate. The purpose of this study was to compare CT histogram analysis and chemical shift MRI in the characterization of indeterminate adrenal nodules. MATERIALS AND METHODS: Thirty-nine adrenal masses that were indeterminate on CT were identified in 37 patients. Histogram analysis was performed on unenhanced CT from a region of interest (ROI) that recorded mean attenuation, number of pixels, and percentage of negative pixels. MR signal intensity drop between the in- and opposed-phase images was measured for the masses. Analyses to determine whether correlations existed among the mean CT attenuation, percentage of negative pixels, and MR signal intensity drop were performed. A final diagnosis was obtained by pathology results, follow-up of more than 6 months, or adrenal washout CT findings. RESULTS: Negative pixels were present in 25 of 28 adenomas and nine of 11 nonadenomas. A threshold of more than 10% negative pixels for the diagnosis of adenoma provided a sensitivity of 46% and specificity of 100%. A threshold of more than 20% MR signal intensity drop yielded a sensitivity of 71% and specificity of 100%. An increase in the percentage of negative pixels was correlated with a decrease in mean CT attenuation. Using MRI, observers characterized seven additional nodules as adenomas compared with CT histogram analysis (McNemar test, chi2 = 5.1429; p = 0.023). CONCLUSION: CT histogram analysis with a threshold of a 10% negative pixel presence increases sensitivity for the characterization of adenomas compared with analysis of the mean CT attenuation alone. The use of chemical shift MRI with a threshold of 20% signal intensity drop results in a higher sensitivity than CT histogram analysis.
Affiliation:
Department of Medical Imaging, University Health Network and Mount Sinai Hospital, Princess Margaret Hospital, 610 University Ave., Toronto, ON M5G 2M9, Canada. kartik.jhaveri@uhn.on.ca
Citation:
Comparison of CT histogram analysis and chemical shift MRI in the characterization of indeterminate adrenal nodules. 2006, 187 (5):1303-8 AJR Am J Roentgenol
Journal:
AJR. American Journal of Roentgenology
Issue Date:
Nov-2006
URI:
http://hdl.handle.net/10541/72548
DOI:
10.2214/AJR.05.1022
PubMed ID:
17056920
Type:
Article
Language:
en
ISSN:
1546-3141
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorJhaveri, Kartik S-
dc.contributor.authorWong, Fenella-
dc.contributor.authorGhai, Sangeet-
dc.contributor.authorHaider, Masoom A-
dc.date.accessioned2009-07-06T10:56:06Z-
dc.date.available2009-07-06T10:56:06Z-
dc.date.issued2006-11-
dc.identifier.citationComparison of CT histogram analysis and chemical shift MRI in the characterization of indeterminate adrenal nodules. 2006, 187 (5):1303-8 AJR Am J Roentgenolen
dc.identifier.issn1546-3141-
dc.identifier.pmid17056920-
dc.identifier.doi10.2214/AJR.05.1022-
dc.identifier.urihttp://hdl.handle.net/10541/72548-
dc.description.abstractOBJECTIVE: Adrenal nodules having an attenuation of more than 10 H on unenhanced CT are considered indeterminate. The purpose of this study was to compare CT histogram analysis and chemical shift MRI in the characterization of indeterminate adrenal nodules. MATERIALS AND METHODS: Thirty-nine adrenal masses that were indeterminate on CT were identified in 37 patients. Histogram analysis was performed on unenhanced CT from a region of interest (ROI) that recorded mean attenuation, number of pixels, and percentage of negative pixels. MR signal intensity drop between the in- and opposed-phase images was measured for the masses. Analyses to determine whether correlations existed among the mean CT attenuation, percentage of negative pixels, and MR signal intensity drop were performed. A final diagnosis was obtained by pathology results, follow-up of more than 6 months, or adrenal washout CT findings. RESULTS: Negative pixels were present in 25 of 28 adenomas and nine of 11 nonadenomas. A threshold of more than 10% negative pixels for the diagnosis of adenoma provided a sensitivity of 46% and specificity of 100%. A threshold of more than 20% MR signal intensity drop yielded a sensitivity of 71% and specificity of 100%. An increase in the percentage of negative pixels was correlated with a decrease in mean CT attenuation. Using MRI, observers characterized seven additional nodules as adenomas compared with CT histogram analysis (McNemar test, chi2 = 5.1429; p = 0.023). CONCLUSION: CT histogram analysis with a threshold of a 10% negative pixel presence increases sensitivity for the characterization of adenomas compared with analysis of the mean CT attenuation alone. The use of chemical shift MRI with a threshold of 20% signal intensity drop results in a higher sensitivity than CT histogram analysis.en
dc.language.isoenen
dc.subject.meshAdenoma-
dc.subject.meshAdrenal Gland Neoplasms-
dc.subject.meshAdrenal Glands-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshImage Processing, Computer-Assisted-
dc.subject.meshMagnetic Resonance Imaging-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshTomography, X-Ray Computed-
dc.titleComparison of CT histogram analysis and chemical shift MRI in the characterization of indeterminate adrenal nodules.en
dc.typeArticleen
dc.contributor.departmentDepartment of Medical Imaging, University Health Network and Mount Sinai Hospital, Princess Margaret Hospital, 610 University Ave., Toronto, ON M5G 2M9, Canada. kartik.jhaveri@uhn.on.caen
dc.identifier.journalAJR. American Journal of Roentgenologyen

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