RT Journal Article
SR Electronic
A1 Ctvrtlik, Filip
A1 Tudos, Zbynek
A1 Szasz, Paulina
A1 Sedlackova, Zuzana
A1 Hartmann, Igor
A1 Schovanek, Jan
A1 Frysak, Zdenek
A1 Macova, Iva
A1 Zelinka, Tomas
A1 Hora, Milan
A1 Kocova, Eva
A1 Pacovsky, Jaroslav
A1 Krsek, Michal
A1 Lehotska, Viera
A1 Mojtova, Emilia
A1 Molnar, Josef
A1 Vanek, Vladimir
A1 Pacak, Karel
A1 Baxa, Jan
T1 Characteristic CT features of pheochromocytomas - probability model calculation tool based on a multicentric study
JF Biomedical papers
YR 2019
VO 163
IS 3
SP 212
OP 219
UL https://biomed.papers.upol.cz/artkey/bio-201903-0004.php
AB Objectives: The aim of the study was to evaluate the CT features of adrenal tumors in an effort to identify features specific to pheochromocytomas and second, to define a feasible probability calculation model. Methods: This multicentric retrospective study included patients from the period 2003 to 2017 with an appropriate CT examination and a histological diagnosis of an adrenal adenoma, pheochromocytoma, adrenocortical carcinoma, or metastasis. In total, 346 patients were suitable for the CT image analysis, which included evaluation of the largest diameter, the shape of the lesion, the presence of central necrosis and its margins, and the presence of an enhancing peripheral rim ("ring sign"). Results: Pheochromocytomas have a significantly more spherical shape (P<0.001), whereas an elliptical shape significantly reduces the probability of a pheochromocytoma (odds ratio = 0.015), as does another shape (odds ratio = 0.006). A "ring sign" is also more frequent in pheochromocytomas compared to other adrenal tumors (P=0.001, odds ratio = 6.49). A sharp necrosis also increases the probability of a pheochromocytoma more than unsharp necrosis (odds ratio 231.6 vs. 20.2). The probability calculation model created on the basis of the results confirms a high sensitivity and specificity (80% and 95%).Conclusion: This study confirms the value of anatomical features in the assessment of adrenal masses with the ability to significantly improve the identification of pheochromocytomas. Advanced assessment of the tumor shape was defined and a original comprehensive calculating tool of the pheochromocytoma probability was created on the basis of the results presented here and could be used in clinical routine.