ECE2016 Eposter Presentations Adrenal cortex (to include Cushing's) (85 abstracts)
Radiological formula for differentiating between secreting and non secreting adrenal adenomas
Valentina Vicennati 2 , Elena Casadio 2 , Uberto Pagotto 2 , Guido Di Dalmazi 2, , Eleonora Rinaldi 2 , Cristina Mosconi 1 , Dimitris Papadopoulos 1 , Rita Golfieri 1 & Renato Pasquali 2
1Radiologic Unit, Department of Diagnostic and Preventive Medicine, Alma Mater Studiorum-University, Bologna, Italy; 2Endocrinology Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum-University, Bologna, Italy; 3Medizinische Klinik und Poliklinik IV, Klinikum der Universitat, Munchen, Germany.
Introduction: Purpose of this study is to find a radiological score and to correlate radiological characteristics of adrenal adenomas and functional parameters to predict subclinical glucocorticoid secretion.
Methods and materials: This retrospective study included 55 patients with adenomas, investigated through CT with adrenal protocol assessing diameters, HU values of the unenhanced and contrast enhanced phases (enhanced–E, and 15 min delayed enhanced–D). Patients underwent dexamethasone overnight suppression test 1 mg (DST). Post-DST cortisol >50 nmol/l identified subclinical cortisol secretion.
We identified 28 subjects with typical non secreting adenomas (NSA), nine with typical secreting adenoma (SA), 11 with atypical NSA and seven with atypical SA.
Results: The post-DST cortisol value was significantly and positively related to mass diameters. At univariate analyses only the two diameters were significantly related to post-DST cortisol (P<0.001), while at the stepwise multivariate analysis the minimum diameter first entered the procedure (P<0.001) and E also added a significant (P=0.027) contribution to the relationship (overall r2=0.334; P<0.001). The correlation coefficients showed that, while the minimum diameter alone accounted for 26.8% of the variability of post-DST cortisol, the accounted variability of post-DST cortisol increased to 33.4% after the addition of E. The radiological score to discriminate SAs versus NSAs resulted in 0.2034×minimum diameter+0.0378×E.
Diagnostic accuracy in differentiating SAs from NSAs was 86.0%, sensitivity 90.9% and specificity 71.8%, considering SA in patients having a score >7.21 and NSA if <7.16.
Conclusion: This study confirms the relation between adenoma’s size and glucocorticoid secretion. It also shows that, using the predictive radiological score, a more evident nodular pattern and a greater vascularity of the lesion corresponds to a greater functional activity.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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