Diagnostic accuracy of computed tomography to identify adenomas among adrenal incidentalomas in an endocrinological population
| dc.rights.license | open | en_US |
| dc.contributor.author | MARTY, M. | |
| dc.contributor.author | GAYE, D. | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | PEREZ, Paul | |
| dc.contributor.author | AUDER, C. | |
| dc.contributor.author | NUNES, M. L. | |
| dc.contributor.author | FERRIERE, A. | |
| dc.contributor.author | HAISSAGUERRE, M. | |
| dc.contributor.author | TABARIN, A. | |
| dc.date.accessioned | 2020-12-07T10:12:03Z | |
| dc.date.available | 2020-12-07T10:12:03Z | |
| dc.date.issued | 2018-05 | |
| dc.identifier.issn | 0804-4643 | en_US |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/21319 | |
| dc.description.abstractEn | CONTEXT: The recent recommendations of the European Endocrine Society states that the performance of computed tomography (CT) to characterize 'true' adrenal incidentalomas (AIs) remains debatable. OBJECTIVE: To determine relevant thresholds for usual CT parameters for the diagnosis of benign tumors using robust reference standard among a large series of 'true' AIs recruited in an endocrinological setting. DESIGN: Retrospective study of 253 AIs in 233 consecutive patients explored in a single university hospital: 183 adenomas, 33 pheochromocytomas, 23 adrenocortical carcinomas, 5 other malignant tumors and 9 other benign tumors. Reference standard was histopathology in 118 AIs, biological diagnosis of pheochromocytoma in 2 AIs and size stability after at least 1 year of follow-up in 133 AIs. METHODS: Sensitivity, specificity and positive and negative predictive values were estimated for various thresholds of size, unenhanced attenuation (UA), relative and absolute wash-out (RPW, APW) of contrast media. 197 scans were reviewed independently in a blinded fashion by two expert radiologists to assess inter-observer reproducibility of measurements. RESULTS: Criteria associated with a 100% positive predictive value for the diagnosis of benign AI were: a combination of size and UA: 30 mm and 20 HU or 40 mm and 15 HU, respectively; RPW >53%; and APW >78%. Non-adenomatous AIs with rapid contrast wash-out were exclusively benign pseudocysts and pheochromocytomas, suggesting that classical thresholds of 60% and 40% for APW and RPW, respectively, can be safely used for patients with normal metanephrine values. Inter-observer reproducibility of all parameters was excellent (intra-class correlation coefficients: 0.96-0.99). CONCLUSIONS: Our study, the largest conducted in AIs recruited in an endocrinological setting, suggests safe thresholds for quantitative CT parameters to avoid false diagnoses of benignity. | |
| dc.language.iso | EN | en_US |
| dc.subject.en | USMR | |
| dc.subject.en | CIC1401 | |
| dc.title.en | Diagnostic accuracy of computed tomography to identify adenomas among adrenal incidentalomas in an endocrinological population | |
| dc.title.alternative | Eur J Endocrinol | en_US |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1530/eje-17-1056 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Santé publique et épidémiologie | en_US |
| dc.identifier.pubmed | 29467231 | en_US |
| bordeaux.journal | European journal of endocrinology | en_US |
| bordeaux.page | 439-446 | en_US |
| bordeaux.volume | 178 | en_US |
| bordeaux.hal.laboratories | Bordeaux Population Health Research Center (BPH) - UMR 1219 | en_US |
| bordeaux.issue | 5 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.team | USMR | en_US |
| bordeaux.team | CIC1401 | en_US |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| hal.identifier | hal-03043247 | |
| hal.version | 1 | |
| hal.date.transferred | 2020-12-07T10:12:08Z | |
| hal.export | true | |
| bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=European%20journal%20of%20endocrinology&rft.date=2018-05&rft.volume=178&rft.issue=5&rft.spage=439-446&rft.epage=439-446&rft.eissn=0804-4643&rft.issn=0804-4643&rft.au=MARTY,%20M.&GAYE,%20D.&PEREZ,%20Paul&AUDER,%20C.&NUNES,%20M.%20L.&rft.genre=article |
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