ECE2018 Guided Posters Adrenal medulla and NETs (11 abstracts)
The 10 Hounsfield Units cut-off value on unenhanced CT imaging is highly sensitive to diagnose pheochromocytoma: a multicenter study
E Buitenwerf 1 , T Korteweg 2 , MSC Haag 2 , RA Feelders 3 , HJLM Timmers 4 , L Canu 4, , HR Haak 6, , PHLT Bisschop 9 , EMW Eekhoff 10 , EPM Corssmit 11 , RPF Dullaart 1 , TP Links 1 & MN Kerstens 1
1Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; 2Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; 3Department of Endocrinology, Erasmus Medical Center, Rotterdam, Rotterdam, The Netherlands; 4Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; 5Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy; 6Department of Internal Medicine, Máxima Medical Center, Eindhoven, Eindhoven, The Netherlands; 7Department of Internal Medicine, Division of General Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands; 8Maastricht University, CAPHRI School for Public Health and Primary Care, Ageing and Long-Term Care, Maastricht, The Netherlands; 9Department of Endocrinology and Metabolism, Academic Medical Center, Amsterdam, Netherlands; 10Internal Medicine, Endocrinology Section, VU University Medical Center, Amsterdam, Netherlands; 11Departments of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands.
Introduction: A substantial proportion of pheochromocytomas (PCC) are detected during the work-up of an adrenal incidentaloma. Recently it has been suggested that in case of an adrenal incidentaloma with an unenhanced attenuation value <10 Hounsfield Units (HU) on CT imaging biochemical testing to rule out PCC is unnecessary. We aimed to determine the sensitivity of the 10 HU cut-off value to detect pheochromocytoma.
Methods: Retrospective multicenter study with reassessment of preoperative unenhanced CT-scans performed in patients in whom a histopathologically proven PCC had been diagnosed from 2000 until 2017. Tumor characteristics including unenhanced attenuation values, were determined independently by two experienced radiologists. Sensitivity of the 10 HU threshold was calculated and interobserver consistency was assessed using the intraclass correlation coefficient (ICC). Data are provided as mean +/−SD or median with IQR, where appropriate.
Results: For this analysis 214 patients were identified harboring a total number of 222 PCC. Maximum tumor diameter was 51 [39–74] millimeter. The mean attenuation value in the transversal plane was 36±10 HU. There was only one pheochromocytoma with an attenuation value <10 HU resulting in a sensitivity of 99.6% (95% CI: 97.5–99.9). ICC was 0.81 (95% CI: 0.75–0.86) with a standard error of measurement of 7.3 HU between radiologists.
Conclusion: The likelihood to encounter a PCC with an unenhanced attenuation value <10 HU on CT imaging is very low. This supports the recommendation to only perform biochemical testing to rule out pheochromocytoma in patients with an adrenal incidentaloma demonstrating unenhanced attenuation values >10 HU. The interobserver consistency in attenuation measurement is excellent.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more