Comparison of CT histogram analysis and chemical shift MRI in the characterization of indeterminate adrenal nodules.
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.caIssue Date
2006-11
Metadata
Show full item recordAbstract
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.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 RoentgenolJournal
AJR. American Journal of RoentgenologyDOI
10.2214/AJR.05.1022PubMed ID
17056920Type
ArticleLanguage
enISSN
1546-3141ae974a485f413a2113503eed53cd6c53
10.2214/AJR.05.1022
Scopus Count
Collections
Related articles
- Comparison of computed tomography histogram analysis and chemical-shift magnetic resonance imaging for adrenal mass characterization.
- Authors: Halefoglu AM, Yasar A, Bas N, Ozel A, Erturk SM, Basak M
- Issue date: 2009 Nov
- Differentiation of adrenal adenomas from nonadenomas using CT histogram analysis method: a prospective study.
- Authors: Halefoglu AM, Bas N, Yasar A, Basak M
- Issue date: 2010 Mar
- Adrenal masses: CT characterization with histogram analysis method.
- Authors: Bae KT, Fuangtharnthip P, Prasad SR, Joe BN, Heiken JP
- Issue date: 2003 Sep
- Lipid-poor adenomas on unenhanced CT: does histogram analysis increase sensitivity compared with a mean attenuation threshold?
- Authors: Ho LM, Paulson EK, Brady MJ, Wong TZ, Schindera ST
- Issue date: 2008 Jul
- Histogram analysis for characterization of indeterminate adrenal nodules on noncontrast CT.
- Authors: Lin MF, Chang-Sen LQ, Heiken JP, Pilgram TK, Bae KT
- Issue date: 2015 Aug