Wendy Tu1, Rosalind Gerson2, Jorge Abreu-Gomez3, Amar Udare4, Rachel Mcphedran2, Nicola Schieda5,6. 1. Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA. 2. Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada. 3. Joint Department of Medical Imaging, The University Health Network, Toronto, ON, Canada. 4. Juravinski Hospital, Hamilton Health Sciences, Hamilton, ON, Canada. 5. Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada. nschieda@toh.on.ca. 6. C1 Radiology, The Ottawa Hospital, University of Ottawa, 1053 Carling Avenue, Ottawa, ON, K1Y 4E9, Canada. nschieda@toh.on.ca.
Abstract
OBJECTIVE: To compare MR-imaging features in benign lipid-rich and lipid-poor adrenal adenomas. MATERIALS AND METHODS: With institutional review board approval, we compared 23 consecutive lipid-poor adenomas (chemical shift [CS] signal intensity [SI] index < 16.5%) imaged with MRI to 29 consecutive lipid-rich adenomas (CS-SI index ≥ 16.5%) imaged during the same time period. A blinded radiologist measured T2-weighted (T2W) SI ratio (adrenal adenoma/psoas muscle), dynamic enhancement wash-in (WI) and wash-out (WO) indices, and T2W texture features. Two blinded Radiologists (R1/R2) assessed T2W-SI (relative to renal cortex) and T2W heterogeneity (using 5-Point Likert scales). Comparisons were performed between groups using independent t tests and Chi-square with Holm-Bonferroni correction. RESULTS: There was no difference in age or gender between groups (p = 0.594, 0.051 respectively). Subjectively, all lipid-rich and lipid-poor adenomas were rated hypointense or isointense compared to renal cortex and T2W-SI did not differ between groups (p = 0.129, 0.124 for R1, R2). Agreement was substantial (Kappa = 0.67). There was no difference in T2W SI ratio (1.8 ± 0.9 [0.5-4.3] lipid rich versus 2.2 ± 1.0 [0.6-4.3] lipid poor, p = 0.139). Enhancement WI and WO did not differ comparing lipid-rich and lipid-poor adenomas (p = 0.759, 0.422 respectively). There was no difference comparing lipid-rich and lipid-poor adenomas T2W heterogeneity judged subjectively (p = 0.695, 0.139 for R1, R2; Kappa = 0.19) or by texture analysis (entropy, kurtosis, skewness; p = 0.134-0.191) with all adenomas except for one rated as mostly or completely homogeneous. CONCLUSIONS: There is no difference in T2W signal intensity, enhancement pattern or T2W heterogeneity judged subjectively or by quantitative texture analysis comparing lipid-poor and lipid-rich adrenal adenomas.
OBJECTIVE: To compare MR-imaging features in benign lipid-rich and lipid-poor adrenal adenomas. MATERIALS AND METHODS: With institutional review board approval, we compared 23 consecutive lipid-poor adenomas (chemical shift [CS] signal intensity [SI] index < 16.5%) imaged with MRI to 29 consecutive lipid-rich adenomas (CS-SI index ≥ 16.5%) imaged during the same time period. A blinded radiologist measured T2-weighted (T2W) SI ratio (adrenal adenoma/psoas muscle), dynamic enhancement wash-in (WI) and wash-out (WO) indices, and T2W texture features. Two blinded Radiologists (R1/R2) assessed T2W-SI (relative to renal cortex) and T2W heterogeneity (using 5-Point Likert scales). Comparisons were performed between groups using independent t tests and Chi-square with Holm-Bonferroni correction. RESULTS: There was no difference in age or gender between groups (p = 0.594, 0.051 respectively). Subjectively, all lipid-rich and lipid-poor adenomas were rated hypointense or isointense compared to renal cortex and T2W-SI did not differ between groups (p = 0.129, 0.124 for R1, R2). Agreement was substantial (Kappa = 0.67). There was no difference in T2W SI ratio (1.8 ± 0.9 [0.5-4.3] lipid rich versus 2.2 ± 1.0 [0.6-4.3] lipid poor, p = 0.139). Enhancement WI and WO did not differ comparing lipid-rich and lipid-poor adenomas (p = 0.759, 0.422 respectively). There was no difference comparing lipid-rich and lipid-poor adenomas T2W heterogeneity judged subjectively (p = 0.695, 0.139 for R1, R2; Kappa = 0.19) or by texture analysis (entropy, kurtosis, skewness; p = 0.134-0.191) with all adenomas except for one rated as mostly or completely homogeneous. CONCLUSIONS: There is no difference in T2W signal intensity, enhancement pattern or T2W heterogeneity judged subjectively or by quantitative texture analysis comparing lipid-poor and lipid-rich adrenal adenomas.
Entities:
Keywords:
Adrenal gland neoplasms; Magnetic resonance imaging; Metastasis; Neoplasm
Authors: Martha A Zeiger; Geoffrey B Thompson; Quan-Yang Duh; Amir H Hamrahian; Peter Angelos; Dina Elaraj; Elliott Fishman; Julia Kharlip Journal: Endocr Pract Date: 2009 Jul-Aug Impact factor: 3.443
Authors: Minal J Sangwaiya; Giles W L Boland; Carmel G Cronin; Michael A Blake; Elkan F Halpern; Peter F Hahn Journal: Radiology Date: 2010-08 Impact factor: 11.105
Authors: Lincoln L Berland; Stuart G Silverman; Richard M Gore; William W Mayo-Smith; Alec J Megibow; Judy Yee; James A Brink; Mark E Baker; Michael P Federle; W Dennis Foley; Isaac R Francis; Brian R Herts; Gary M Israel; Glenn Krinsky; Joel F Platt; William P Shuman; Andrew J Taylor Journal: J Am Coll Radiol Date: 2010-10 Impact factor: 5.532
Authors: M Korobkin; T J Lombardi; A M Aisen; I R Francis; L E Quint; N R Dunnick; F Londy; B Shapiro; M D Gross; N W Thompson Journal: Radiology Date: 1995-11 Impact factor: 11.105