Characterization of adrenal masses with diffusion-weighted imaging

Kumar Sandrasegaran, Aashish A. Patel, Raja Ramaswamy, Victor P. Samuel, Benjamin G. Northcutt, Mark S. Frank, Isaac R. Francis

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this article is to assess the role of diffusion-weighted MRI in characterizing adrenal masses. MATERIALS AND METHODS. A retrospective review of the MRI database from August 2007 to July 2009 was performed. The MRI examinations of 48 patients, with 49 lesions, were reviewed independently and blindly by two experienced abdominal radiologists who measured the signal intensities on in-phase and opposed-phase T1-weighted imaging and apparent diffusion coefficient (ADC). ADC measurements and quantitative parameters of chemical shift imaging (signal intensity index and adrenal-to-spleen ratio) were assessed separately and in combination. Lesions with indeterminate signal intensity index (< 16.5%) were considered benign if ADC was greater than or equal to 1.0 × 10-3 mm2/s and malignant if ADC was less than 1.0 × 10-3 mm2/s. Stepwise logistic regression analysis and receiver operating characteristic curves analysis were performed. RESULTS. There were 12 malignant and 37 benign lesions. On multivariate analysis, the only significant predictors of lesion status were signal intensity index from reviewer 2 (p = 0.05) and lesion size (p = 0.04); ADC values were not found to be useful. On receiver operating characteristic curve analysis, there was no significant difference in area under the curve for ADC, signal intensity index, adrenal-to-spleen ratio, or the combined signal intensity index and ADC assessment. For lesions that were indeterminate according to signal intensity index, ADC values greater than 1.50 × 10-3 mm2/s were found only in benign lesions, and nine of 11 lesions with ADC less than 1.0 × 10-3 mm 2/s were malignant. CONCLUSION. In general, ADC values are not useful in differentiating adrenal lesions. However, when ADC values are applied to lesions that are indeterminate on signal intensity index, they may help in differentiating a subset of benign and malignant lesions.

Original languageEnglish
Pages (from-to)132-138
Number of pages7
JournalAmerican Journal of Roentgenology
Volume197
Issue number1
DOIs
StatePublished - Jul 2011

Fingerprint

ROC Curve
Spleen
Diffusion Magnetic Resonance Imaging
Area Under Curve
Multivariate Analysis
Logistic Models
Regression Analysis
Magnetic Resonance Imaging
Databases
Radiologists

Keywords

  • Adenoma
  • Adrenal gland
  • Chemical shift imaging
  • Diffusion-weighted imaging
  • MRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Sandrasegaran, K., Patel, A. A., Ramaswamy, R., Samuel, V. P., Northcutt, B. G., Frank, M. S., & Francis, I. R. (2011). Characterization of adrenal masses with diffusion-weighted imaging. American Journal of Roentgenology, 197(1), 132-138. https://doi.org/10.2214/AJR.10.4583

Characterization of adrenal masses with diffusion-weighted imaging. / Sandrasegaran, Kumar; Patel, Aashish A.; Ramaswamy, Raja; Samuel, Victor P.; Northcutt, Benjamin G.; Frank, Mark S.; Francis, Isaac R.

In: American Journal of Roentgenology, Vol. 197, No. 1, 07.2011, p. 132-138.

Research output: Contribution to journalArticle

Sandrasegaran, K, Patel, AA, Ramaswamy, R, Samuel, VP, Northcutt, BG, Frank, MS & Francis, IR 2011, 'Characterization of adrenal masses with diffusion-weighted imaging', American Journal of Roentgenology, vol. 197, no. 1, pp. 132-138. https://doi.org/10.2214/AJR.10.4583
Sandrasegaran, Kumar ; Patel, Aashish A. ; Ramaswamy, Raja ; Samuel, Victor P. ; Northcutt, Benjamin G. ; Frank, Mark S. ; Francis, Isaac R. / Characterization of adrenal masses with diffusion-weighted imaging. In: American Journal of Roentgenology. 2011 ; Vol. 197, No. 1. pp. 132-138.
@article{20e05e6e6eb246b2a18bfb0a687a8af5,
title = "Characterization of adrenal masses with diffusion-weighted imaging",
abstract = "OBJECTIVE. The purpose of this article is to assess the role of diffusion-weighted MRI in characterizing adrenal masses. MATERIALS AND METHODS. A retrospective review of the MRI database from August 2007 to July 2009 was performed. The MRI examinations of 48 patients, with 49 lesions, were reviewed independently and blindly by two experienced abdominal radiologists who measured the signal intensities on in-phase and opposed-phase T1-weighted imaging and apparent diffusion coefficient (ADC). ADC measurements and quantitative parameters of chemical shift imaging (signal intensity index and adrenal-to-spleen ratio) were assessed separately and in combination. Lesions with indeterminate signal intensity index (< 16.5{\%}) were considered benign if ADC was greater than or equal to 1.0 × 10-3 mm2/s and malignant if ADC was less than 1.0 × 10-3 mm2/s. Stepwise logistic regression analysis and receiver operating characteristic curves analysis were performed. RESULTS. There were 12 malignant and 37 benign lesions. On multivariate analysis, the only significant predictors of lesion status were signal intensity index from reviewer 2 (p = 0.05) and lesion size (p = 0.04); ADC values were not found to be useful. On receiver operating characteristic curve analysis, there was no significant difference in area under the curve for ADC, signal intensity index, adrenal-to-spleen ratio, or the combined signal intensity index and ADC assessment. For lesions that were indeterminate according to signal intensity index, ADC values greater than 1.50 × 10-3 mm2/s were found only in benign lesions, and nine of 11 lesions with ADC less than 1.0 × 10-3 mm 2/s were malignant. CONCLUSION. In general, ADC values are not useful in differentiating adrenal lesions. However, when ADC values are applied to lesions that are indeterminate on signal intensity index, they may help in differentiating a subset of benign and malignant lesions.",
keywords = "Adenoma, Adrenal gland, Chemical shift imaging, Diffusion-weighted imaging, MRI",
author = "Kumar Sandrasegaran and Patel, {Aashish A.} and Raja Ramaswamy and Samuel, {Victor P.} and Northcutt, {Benjamin G.} and Frank, {Mark S.} and Francis, {Isaac R.}",
year = "2011",
month = "7",
doi = "10.2214/AJR.10.4583",
language = "English",
volume = "197",
pages = "132--138",
journal = "American Journal of Roentgenology",
issn = "0361-803X",
publisher = "American Roentgen Ray Society",
number = "1",

}

TY - JOUR

T1 - Characterization of adrenal masses with diffusion-weighted imaging

AU - Sandrasegaran, Kumar

AU - Patel, Aashish A.

AU - Ramaswamy, Raja

AU - Samuel, Victor P.

AU - Northcutt, Benjamin G.

AU - Frank, Mark S.

AU - Francis, Isaac R.

PY - 2011/7

Y1 - 2011/7

N2 - OBJECTIVE. The purpose of this article is to assess the role of diffusion-weighted MRI in characterizing adrenal masses. MATERIALS AND METHODS. A retrospective review of the MRI database from August 2007 to July 2009 was performed. The MRI examinations of 48 patients, with 49 lesions, were reviewed independently and blindly by two experienced abdominal radiologists who measured the signal intensities on in-phase and opposed-phase T1-weighted imaging and apparent diffusion coefficient (ADC). ADC measurements and quantitative parameters of chemical shift imaging (signal intensity index and adrenal-to-spleen ratio) were assessed separately and in combination. Lesions with indeterminate signal intensity index (< 16.5%) were considered benign if ADC was greater than or equal to 1.0 × 10-3 mm2/s and malignant if ADC was less than 1.0 × 10-3 mm2/s. Stepwise logistic regression analysis and receiver operating characteristic curves analysis were performed. RESULTS. There were 12 malignant and 37 benign lesions. On multivariate analysis, the only significant predictors of lesion status were signal intensity index from reviewer 2 (p = 0.05) and lesion size (p = 0.04); ADC values were not found to be useful. On receiver operating characteristic curve analysis, there was no significant difference in area under the curve for ADC, signal intensity index, adrenal-to-spleen ratio, or the combined signal intensity index and ADC assessment. For lesions that were indeterminate according to signal intensity index, ADC values greater than 1.50 × 10-3 mm2/s were found only in benign lesions, and nine of 11 lesions with ADC less than 1.0 × 10-3 mm 2/s were malignant. CONCLUSION. In general, ADC values are not useful in differentiating adrenal lesions. However, when ADC values are applied to lesions that are indeterminate on signal intensity index, they may help in differentiating a subset of benign and malignant lesions.

AB - OBJECTIVE. The purpose of this article is to assess the role of diffusion-weighted MRI in characterizing adrenal masses. MATERIALS AND METHODS. A retrospective review of the MRI database from August 2007 to July 2009 was performed. The MRI examinations of 48 patients, with 49 lesions, were reviewed independently and blindly by two experienced abdominal radiologists who measured the signal intensities on in-phase and opposed-phase T1-weighted imaging and apparent diffusion coefficient (ADC). ADC measurements and quantitative parameters of chemical shift imaging (signal intensity index and adrenal-to-spleen ratio) were assessed separately and in combination. Lesions with indeterminate signal intensity index (< 16.5%) were considered benign if ADC was greater than or equal to 1.0 × 10-3 mm2/s and malignant if ADC was less than 1.0 × 10-3 mm2/s. Stepwise logistic regression analysis and receiver operating characteristic curves analysis were performed. RESULTS. There were 12 malignant and 37 benign lesions. On multivariate analysis, the only significant predictors of lesion status were signal intensity index from reviewer 2 (p = 0.05) and lesion size (p = 0.04); ADC values were not found to be useful. On receiver operating characteristic curve analysis, there was no significant difference in area under the curve for ADC, signal intensity index, adrenal-to-spleen ratio, or the combined signal intensity index and ADC assessment. For lesions that were indeterminate according to signal intensity index, ADC values greater than 1.50 × 10-3 mm2/s were found only in benign lesions, and nine of 11 lesions with ADC less than 1.0 × 10-3 mm 2/s were malignant. CONCLUSION. In general, ADC values are not useful in differentiating adrenal lesions. However, when ADC values are applied to lesions that are indeterminate on signal intensity index, they may help in differentiating a subset of benign and malignant lesions.

KW - Adenoma

KW - Adrenal gland

KW - Chemical shift imaging

KW - Diffusion-weighted imaging

KW - MRI

UR - http://www.scopus.com/inward/record.url?scp=79960537887&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79960537887&partnerID=8YFLogxK

U2 - 10.2214/AJR.10.4583

DO - 10.2214/AJR.10.4583

M3 - Article

VL - 197

SP - 132

EP - 138

JO - American Journal of Roentgenology

JF - American Journal of Roentgenology

SN - 0361-803X

IS - 1

ER -