AI Article Synopsis
- The study aimed to compare the effectiveness of multiphase hepatic CT parameters and chemical-shift MRI in distinguishing between lipid-poor adrenal adenomas and metastases in patients with hepatocellular carcinoma.
- Researchers analyzed data from 104 HCC patients, measuring various CT and MRI parameters, finding that lipid-poor adenomas had significantly different values compared to metastases for multiple parameters.
- Results showed that multiphase hepatic CT, particularly when using a combination of the relative enhancement ratio (RER) and absolute washout ratio (APW), provided better discrimination between adenomas and metastases than CS-MRI.
Article Abstract
Purpose: To evaluate the diagnostic performance of multiphase hepatic CT parameters (non-contrast attenuation, absolute and relative washout ratios [APW and RPW, respectively], and relative enhancement ratio [RER]) and chemical-shift MRI (CS-MRI) for discriminating lipid-poor adrenal adenomas (with non-contrast CT attenuation > 10 HU) from metastases in patients with hepatocellular carcinoma (HCC).
Methods: This retrospective study included HCC patients with lipid-poor adrenal lesions who underwent multiphase hepatic CT between January 2010 and December 2021. For each adrenal lesion, non-contrast attenuation, APW, RPW, RER, and signal-intensity index (SI-index) were measured. Each parameter was compared between adenomas and metastases. The area under the receiver operating characteristic curves (AUCs) and sensitivities to achieve 100% specificity for adenoma diagnoses were determined.
Results: 104 HCC patients (78 men; mean age, 71.8 ± 9.6 years) with 63 adenomas and 48 metastases were identified; CS-MRI was performed in 66 patients with 49 adenomas and 21 metastases within one year of CT. Lipid-poor adenomas showed lower non-contrast attenuation (22.9 ± 7.1 vs. 37.9 ± 9.4 HU) and higher APW (40.5% ± 12.8% vs. 23.7% ± 17.4%), RPW (30.0% ± 10.2% vs. 12.4% ± 9.6%), RER (329% ± 152% vs. 111% ± 43.0%), and SI-index (43.3 ± 20.7 vs. 10.8 ± 13.4) than HCC metastases (all p < .001). AUC for non-contrast attenuation, APW, RPW, RER, and SI-index were 0.894, 0.786, 0.904, 0.969, and 0.902, respectively. The sensitivities to achieve 100% specificity were 7.9%, 25.4%, 30.2%, 63.5%, and 24.5%, respectively. Combined RER and APW achieved the highest sensitivity of 73.0%.
Conclusion: Multiphase hepatic CT allows for better discrimination between lipid-poor adrenal adenomas and metastases relative to CS-MRI, especially when combined with RER and washout parameters.
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| http://dx.doi.org/10.1007/s00261-024-04228-5 | DOI Listing |
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Article Synopsis
- The study aimed to investigate the effectiveness of CT quantitative parameters in distinguishing between lipid-poor adenoma (LPA) and nodular hyperplasia in adrenal lesions.
- Researchers analyzed 128 patients, measuring various CT parameters, including attenuation values and lesion volume, and developed a logistic regression model to evaluate diagnostic accuracy.
- The model showed a good performance with an area under the ROC curve (AUC) of 0.835, with better sensitivity and specificity than radiologists' assessments, indicating that CT metrics can be more reliable for diagnosis.
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