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Preresection Radiologic Assessment and Imaging Features of 156 Pathologically Proven Adrenal Adenomas.
Elsherif, Sherif B; Javadi, Sanaz; Blair, Katherine J; Morshid, Ali I; Hui, Ling; Khalaf, Ahmed M; Elbanan, Mohamed G; Zhang, Miao; Habra, Mouhammed A; Elsayes, Khaled M.
Affiliation
  • Elsherif SB; From the Departments of Diagnostic Radiology.
  • Javadi S; From the Departments of Diagnostic Radiology.
  • Blair KJ; From the Departments of Diagnostic Radiology.
  • Morshid AI; Imaging Physics.
  • Hui L; Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX.
  • Khalaf AM; Imaging Physics.
  • Elbanan MG; Department of Radiology, Yale New Haven Health at Bridgeport Hospital, Bridgeport, CT.
  • Zhang M; Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX.
  • Habra MA; Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX.
  • Elsayes KM; From the Departments of Diagnostic Radiology.
J Comput Assist Tomogr ; 44(3): 419-425, 2020.
Article in En | MEDLINE | ID: mdl-32345808
PURPOSE: The aims of the study were to assess the typical and atypical radiologic features of pathologically proven adrenal adenomas and to determine the relationship between the radiologic and histopathologic classification. METHODS: We retrospectively studied 156 pathologically proven adrenal adenomas in 154 patients from our institutional databases who have computed tomography (CT) and/or magnetic resonance imaging (MRI) examinations before intervention. We determined the histopathologic diagnosis (typical or atypical) using Weiss scoring and classified the adenomas radiologically into typical, atypical, or indeterminate based on lesion size, precontrast CT attenuation, absolute percentage washout, calcification, and necrosis. The κ statistic was used to assess the agreement between radiologists. The Fisher exact test was used to compare the radiologic and pathological classifications. RESULTS: In consensus, there were 83 typical, 42 atypical, and 31 indeterminate adrenal lesions. Logistic regression model showed that radiologically atypical adenoma was significantly associated with larger size, lobulated shape, higher unenhanced CT attenuation, heterogeneous appearance, nonfunctioning status, absolute percentage washout of less than 60%, and a signal intensity index of less than 16.5%.Pathologically, 147 adenomas were pathologically typical (Weiss 0), and 9 adenomas were pathologically atypical (Weiss 1-2). Radiologically, there was substantial agreement between both readers, with Cohen κ at 0.71. Approximately 98% of radiologically typical adenomas were pathologically typical. Only 17% of radiologically atypical adenomas were pathologically atypical. All radiologically indeterminate adenomas were pathologically typical. However, some of the radiologically indeterminate and typical adenomas still had an atypical component on pathologic analysis, such as necrosis, nuclear atypia, or oncocytic features. CONCLUSIONS: Radiologically atypical lesion was significantly associated with larger size and higher unenhanced CT attenuation. Approximately 27% of the cases demonstrated atypical features on imaging. Most radiologically atypical adrenal adenomas are pathologically typical.
Subject(s)

Full text: 1 Database: MEDLINE Main subject: Preoperative Care / Tomography, X-Ray Computed / Adrenal Gland Neoplasms Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Aged / Aged80 / Child / Female / Humans / Male / Middle aged Language: En Year: 2020 Type: Article

Full text: 1 Database: MEDLINE Main subject: Preoperative Care / Tomography, X-Ray Computed / Adrenal Gland Neoplasms Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Aged / Aged80 / Child / Female / Humans / Male / Middle aged Language: En Year: 2020 Type: Article