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Differentiation of lipid-poor adenoma from pheochromocytoma on biphasic contrast-enhanced CT

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the diagnostic performance of biphasic contrast-enhanced CT in differentiation of lipid-poor adenomas from pheochromocytomas.

Methods

129 patients with 132 lipid-poor adenomas and 93 patients with 97 pheochromocytomas confirmed by pathology were included in this retrospective study. Patients underwent unenhanced abdominal CT scan followed by arterial and venous phase. Quantitative and qualitative imaging features were compared between the two groups using univariate analysis. Risk factors for pheochromocytomas were evaluated by multivariate logistic regression analysis and a diagnostic scoring model was established based on odd ratio (OR) of the risk factors.

Results

Pheochromocytomas were larger and showed cystic degeneration more frequently compared with lipid-poor adenomas (p < 0.01). No significant difference was found in peak enhancement phase between the two groups (p = 0.348). Attenuation values on unenhanced phase (CTU), arterial phase (CTA), and venous phase (CTV) of pheochromocytomas were significantly higher than that of lipid-poor adenomas while enhancement ratio on arterial and venous phase (ERA, ERV) of pheochromocytomas was significantly lower than that of lipid-poor adenomas (all p < 0.05). Multivariate analysis revealed lesion size > 29 mm (OR: 5.74; 95% CI 2.51–13.16; p < 0.001), CTA > 81 HU (OR: 2.54; 95% CI 1.04–6.17; p = 0.04), CTV > 97 HU (OR: 11.19; 95% CI 3.21–38.97; p < 0.001), ERV ≤ 1.5 (OR: 20.23; 95% CI 6.30–64.87; p < 0.001), and the presence of cystic degeneration (OR: 6.22, 95% CI 1.74–22.25; p = 0.005) were risk factors for pheochromocytomas. The diagnostic scoring model yielded an area under the curve (AUC) of 0.911.

Conclusions

Biphasic contrast-enhanced CT showed good diagnostic performance in differentiation of lipid-poor adenomas from pheochromocytomas.

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Funding

This research was supported by Zhejiang Province Public Welfare Technology Application Research Project (NO. LGF21H030004) and Medical Health Science and Technology Project of Zhejiang Provincial Health Commission (NO. 2018KY410).

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Authors and Affiliations

  1. Department of Radiology, Tongde Hospital of Zhejiang Province, No.234, Gucui Road, Xihu Distinct, Hangzhou, 310012, Zhejiang Province, China

    Yong-yu An, Guang-Zhao Yang, Hong-Tao Hou, Fang-Mei Zhu & Jian Wang

  2. Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang Province, China

    Bin Lin

  3. Department of Urology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang Province, China

    Nan Zhang

  4. Department of Radiology, Sir Run Run Shaw Hospital of Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang Province, China

    Feng-Juan Tian

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  1. Yong-yu An
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Correspondence to Jian Wang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The study was approved by the Institutional Review Board, and informed consent was waived due to retrospective analysis of the study.

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An, Yy., Yang, GZ., Lin, B. et al. Differentiation of lipid-poor adenoma from pheochromocytoma on biphasic contrast-enhanced CT. Abdom Radiol 46, 4353–4361 (2021). https://doi.org/10.1007/s00261-021-03121-9

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  • DOI: https://doi.org/10.1007/s00261-021-03121-9

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