Are current washout values in dedicated adrenal CT sufficient for diagnosis?

What is it about?

The study aimed to differentiate between adrenal adenoma and nonadenoma lesions using CT imaging. The study evaluated 87 pathologically diagnosed masses from 84 patients who underwent adrenalectomy. The findings showed that noncontrast CT density value of ≤0 HU was the most reliable parameter for distinguishing adenomas. However, the sensitivity and specificity of washout criteria (absolute and relative) were lower than reported in previous literature. Some nonadenoma lesions, like pheochromocytoma, exhibited similar washout values to adenomas. Cystic lesions could only be distinguished with contrast examination. Adenomas had smaller size, higher relative washout, lower noncontrast density, and delayed-phase enhancement compared to nonadenoma lesions. The study highlights the limitations and challenges in accurately differentiating between adenoma and nonadenoma lesions using CT imaging, emphasizing the need for careful interpretation and consideration of multiple factors in clinical practice.

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Photo by Accuray on Unsplash

Photo by Accuray on Unsplash

Why is it important?

The differentiation between adrenal adenoma and nonadenoma lesions is important for accurate diagnosis and appropriate management. CT imaging plays a crucial role in this differentiation, as it helps determine the nature of the adrenal mass and guide treatment decisions, such as surgery or close monitoring. Accurate characterization of these lesions can prevent unnecessary surgeries and reduce patient anxiety.