{"title":"单相光谱 CT 导出的细胞外体积分数用于区分肾上腺转移瘤和腺瘤的可行性。","authors":"Mengya Sun, Shulin Ma, Guanglei Tang, Weiwei Deng, Yang Peng, Shuang Yu, Jian Guan","doi":"10.1007/s00261-024-04681-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The extracellular matrix of adrenal metastases could be different from that of the adrenal adenomas, which may be characterized by the extracellular volume (ECV) fraction. This study aimed to assess the feasibility of ECV fraction derived from single-phase spectral CT for differentiating between adrenal metastases and adenomas.</p><p><strong>Methods: </strong>This retrospective study included 163 patients with unilateral nodules, including lipid-poor adrenal adenoma (n = 52, group A), lipid-rich adrenal adenoma (n = 65, group B) and adrenal metastasis (n = 46, group C). All patients underwent contrast-enhanced spectral CT of the adrenal gland with a 10-minute delayed phase. The iodine density of each lesion was assessed and ECV fraction was examined. Various parameters were compared among the three groups. Diagnostic performance was evaluated by quantifying the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>The ECV fraction in group C (33.81 ± 11.94%) was significantly higher than that in group A (20.86 ± 10.22%) and group B (11.44 ± 6.26%) (p < 0.001), while iodine density in group C (0.93 ± 0.41 mg/mL) was also higher than that in group A (0.61 ± 0.33 mg/mL) and group B (0.33 ± 0.19 mg/mL) (p < 0.001). ECV fraction showed significantly higher AUC (AUC = 0.790, 95%CI 0.691-0.869) for differentiating between group A and C than iodine density (AUC = 0.717, 95%CI 0.612-0.808; p = 0.002). Simultaneously, ECV fraction had significantly higher AUC (AUC = 0.945, 95%CI 0.858-0.986) for differentiating between group B and C than iodine density (AUC = 0.897, 95%CI 0.795-0.959, p = 0.03).</p><p><strong>Conclusion: </strong>Based on single 10-minute delayed phase spectral CT, ECV fraction showed high diagnostic performance in differentiating between adrenal metastases and adrenal adenomas, both for lipid-poor or lipid-rich adenomas. The ECV fraction could help recognize metastases in unilateral or bilateral adrenal masses for better treatment planning, especially in patients with a history of extra-adrenal malignancy.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Feasibility of extracellular volume fraction derived from single-phase spectral CT for differentiating between adrenal metastases and adenomas.\",\"authors\":\"Mengya Sun, Shulin Ma, Guanglei Tang, Weiwei Deng, Yang Peng, Shuang Yu, Jian Guan\",\"doi\":\"10.1007/s00261-024-04681-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The extracellular matrix of adrenal metastases could be different from that of the adrenal adenomas, which may be characterized by the extracellular volume (ECV) fraction. This study aimed to assess the feasibility of ECV fraction derived from single-phase spectral CT for differentiating between adrenal metastases and adenomas.</p><p><strong>Methods: </strong>This retrospective study included 163 patients with unilateral nodules, including lipid-poor adrenal adenoma (n = 52, group A), lipid-rich adrenal adenoma (n = 65, group B) and adrenal metastasis (n = 46, group C). All patients underwent contrast-enhanced spectral CT of the adrenal gland with a 10-minute delayed phase. The iodine density of each lesion was assessed and ECV fraction was examined. Various parameters were compared among the three groups. Diagnostic performance was evaluated by quantifying the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>The ECV fraction in group C (33.81 ± 11.94%) was significantly higher than that in group A (20.86 ± 10.22%) and group B (11.44 ± 6.26%) (p < 0.001), while iodine density in group C (0.93 ± 0.41 mg/mL) was also higher than that in group A (0.61 ± 0.33 mg/mL) and group B (0.33 ± 0.19 mg/mL) (p < 0.001). ECV fraction showed significantly higher AUC (AUC = 0.790, 95%CI 0.691-0.869) for differentiating between group A and C than iodine density (AUC = 0.717, 95%CI 0.612-0.808; p = 0.002). Simultaneously, ECV fraction had significantly higher AUC (AUC = 0.945, 95%CI 0.858-0.986) for differentiating between group B and C than iodine density (AUC = 0.897, 95%CI 0.795-0.959, p = 0.03).</p><p><strong>Conclusion: </strong>Based on single 10-minute delayed phase spectral CT, ECV fraction showed high diagnostic performance in differentiating between adrenal metastases and adrenal adenomas, both for lipid-poor or lipid-rich adenomas. The ECV fraction could help recognize metastases in unilateral or bilateral adrenal masses for better treatment planning, especially in patients with a history of extra-adrenal malignancy.</p>\",\"PeriodicalId\":7126,\"journal\":{\"name\":\"Abdominal Radiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-11-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Abdominal Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00261-024-04681-2\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Abdominal Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00261-024-04681-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Feasibility of extracellular volume fraction derived from single-phase spectral CT for differentiating between adrenal metastases and adenomas.
Purpose: The extracellular matrix of adrenal metastases could be different from that of the adrenal adenomas, which may be characterized by the extracellular volume (ECV) fraction. This study aimed to assess the feasibility of ECV fraction derived from single-phase spectral CT for differentiating between adrenal metastases and adenomas.
Methods: This retrospective study included 163 patients with unilateral nodules, including lipid-poor adrenal adenoma (n = 52, group A), lipid-rich adrenal adenoma (n = 65, group B) and adrenal metastasis (n = 46, group C). All patients underwent contrast-enhanced spectral CT of the adrenal gland with a 10-minute delayed phase. The iodine density of each lesion was assessed and ECV fraction was examined. Various parameters were compared among the three groups. Diagnostic performance was evaluated by quantifying the area under the receiver operating characteristic curve (AUC).
Results: The ECV fraction in group C (33.81 ± 11.94%) was significantly higher than that in group A (20.86 ± 10.22%) and group B (11.44 ± 6.26%) (p < 0.001), while iodine density in group C (0.93 ± 0.41 mg/mL) was also higher than that in group A (0.61 ± 0.33 mg/mL) and group B (0.33 ± 0.19 mg/mL) (p < 0.001). ECV fraction showed significantly higher AUC (AUC = 0.790, 95%CI 0.691-0.869) for differentiating between group A and C than iodine density (AUC = 0.717, 95%CI 0.612-0.808; p = 0.002). Simultaneously, ECV fraction had significantly higher AUC (AUC = 0.945, 95%CI 0.858-0.986) for differentiating between group B and C than iodine density (AUC = 0.897, 95%CI 0.795-0.959, p = 0.03).
Conclusion: Based on single 10-minute delayed phase spectral CT, ECV fraction showed high diagnostic performance in differentiating between adrenal metastases and adrenal adenomas, both for lipid-poor or lipid-rich adenomas. The ECV fraction could help recognize metastases in unilateral or bilateral adrenal masses for better treatment planning, especially in patients with a history of extra-adrenal malignancy.
期刊介绍：
Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section.
Reasons to Publish Your Article in Abdominal Radiology:
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European Society of Gastrointestinal and Abdominal Radiology (ESGAR)
European Society of Urogenital Radiology (ESUR)
Asian Society of Abdominal Radiology (ASAR)
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· Global readership
· Readers can earn CME credits
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