Inter-method agreement between wash-in and wash-out computed tomography for characterizing hyperattenuating adrenal lesions as adenomas or non-adenomas
In: European Radiology, Jg. 33 (2022-09-29), S. 2218-2226
Online
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Zugriff:
To investigate inter-method agreement between wash-out and wash-in computed tomography (CT) to determine whether hyperattenuating adrenal lesions are characterized as adenomas or non-adenomas.We evaluated 243 patients who underwent wash-out CT for a solid enhancing hyperattenuating (i.e.,10 Hounsfield unit [HU]) adrenal mass of ≥ 1 to4 cm. Wash-out (absolute percentage wash-out [APW]; relative percentage wash-out [RPW]) and wash-in values (enhancement ratio [ER]; relative enhancement ratio [RER]) were analyzed by two independent readers. Diagnostic criteria of wash-out CT for adenoma were APW ≥ 60% or RPW ≥ 40% (conventional method). Three different criteria for wash-in CT were set: ER ≥ 3.0; RER ≥ 200%; and RER ≥ 210%. Concordance rate and inter-method agreement between wash-out and wash-in CT were investigated using Gwet's AC1.For all lesions, concordance rates between wash-out and wash-in CT were83%. AC1 between conventional method and ER ≥ 3.0 or between conventional method and RER ≥ 200% were identically 0.843 for reader 1 and 0.776 for reader 2. AC1 between conventional method and RER ≥ 210% were 0.780 for reader 1 and 0.737 for reader 2. For lesions of10 to ≤ 30 HU, concordance rates between wash-out and wash-in CT were89%. AC1 between conventional method and ER ≥ 3.0 or between conventional method and RER ≥ 200% were identically 0.914 for reader 1 and 0.866 for reader 2. AC1 between conventional method and RER ≥ 210% were 0.888 for reader 1 and 0.874 for reader 2.In approximately 90% of patients with a hyperattenuating adrenal lesion of ≥ 1 to4 cm and10 to ≤ 30 HU, wash-out CT with 15-min contrast-enhanced images may be replaced by wash-in CT.• An enhancement ratio of ≥ 3.0 or a relative enhancement ratio of ≥ 200% appears to be appropriate as the threshold of wash-in computed tomography (CT) comprising unenhanced and 1-min contrast-enhanced CT. • Measurement of enhancement ratio or relative enhancement ratio was reproducible. • We found good agreement between wash-in and wash-out CT for determining whether hyperattenuating adrenal lesions of ≥ 1 to4 cm and10 to ≤ 30 Hounsfield unit would be characterized as adenomas.
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Inter-method agreement between wash-in and wash-out computed tomography for characterizing hyperattenuating adrenal lesions as adenomas or non-adenomas
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Autor/in / Beteiligte Person: | Min Ju Kim ; Kyung A Kang ; Chan Kyo Kim ; Sung Yoon Park |
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Zeitschrift: | European Radiology, Jg. 33 (2022-09-29), S. 2218-2226 |
Veröffentlichung: | Springer Science and Business Media LLC, 2022 |
Medientyp: | unknown |
ISSN: | 1432-1084 (print) |
DOI: | 10.1007/s00330-022-09144-0 |
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