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Navin PJ, Moynagh MR. Optimal and novel imaging of the adrenal glands. Curr Opin Endocrinol Diabetes Obes 2022; 29:253-262. [PMID: 35621177 DOI: 10.1097/med.0000000000000730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Adrenal imaging forms an important role in the workup of adrenal masses. The purpose of this review is to briefly review the traditional role of imaging in adrenal diseases and highlight the most recent research and new applications aimed to improve diagnostic accuracy. RECENT FINDINGS The current review will focus on new applications of computed tomography (CT), MRI and PET/CT imaging, addressing the implications of artificial intelligence and radiomics in progressing diagnostic accuracy. SUMMARY The new applications of adrenal imaging are improving diagnostic accuracy and expanding the role of imaging, particularly with novel PET radiotracers and the use of artificial intelligence.
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Affiliation(s)
- Patrick J Navin
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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Stanzione A, Verde F, Galatola R, Romeo V, Liuzzi R, Mainenti PP, Aprea G, Klain M, Guadagno E, Del Basso De Caro M, Maurea S. Qualitative Heterogeneous Signal Drop on Chemical Shift (CS) MR Imaging: Correlative Quantitative Analysis between CS Signal Intensity Index and Contrast Washout Parameters Using T1-Weighted Sequences. Tomography 2021; 7:961-971. [PMID: 34941651 PMCID: PMC8709007 DOI: 10.3390/tomography7040079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/08/2021] [Accepted: 12/10/2021] [Indexed: 12/16/2022] Open
Abstract
The aim of this study was to calculate MRI quantitative parameters extracted from chemical-shift (CS) and dynamic contrast-enhanced (DCE) T1-weighted (T1-WS) images of adrenal lesions (AL) with qualitative heterogeneous signal drop on CS T1-WS and compare them to those of AL with homogeneous or no signal drop on CS T1-WS. On 3 T MRI, 65 patients with a total of 72 AL were studied. CS images were qualitatively assessed for grouping AL as showing homogeneous (Group 1, n = 19), heterogeneous (Group 2, n = 23), and no (Group 3, n = 30) signal drop. Histopathology or follow-up data served as reference standard to classify AL. ROIs were drawn both on CS and DCE images to obtain adrenal CS signal intensity index (ASII), absolute (AWO), and relative washout (RWO) values. Quantitative parameters (QP) were compared with ANOVA analysis and post hoc Dunn’s test. The performance of QP to classify AL was assessed with receiver operating characteristic analysis. CS ASII values were significantly different among the three groups (p < 0.001) with median values of 71%, 53%, and 3%, respectively. AWO/RWO values were similar in Groups 1 (adenomas) and 2 (benign AL) but significantly (p < 0.001) lower in Group 3 (20 benign AL and 10 malignant AL). With cut-offs, respectively, of 60% (Group 1 vs. 2), 20% (Group 2 vs. 3), and 37% (Group 1 vs. 3), CS ASII showed areas under the curve of 0.85, 0.96, and 0.93 for the classification of AL, overall higher than AWO/RWO. In conclusion, AL with qualitative heterogeneous signal drop at CS represent benign AL with QP by DCE sequence similar to those of AL with homogeneous signal drop at CS, but different to those of AL with no signal drop at CS; ASII seems to be the only quantitative parameter able to differentiate AL among the three different groups.
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Affiliation(s)
- Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (F.V.); (V.R.); (M.K.); (E.G.); (M.D.B.D.C.); (S.M.)
| | - Francesco Verde
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (F.V.); (V.R.); (M.K.); (E.G.); (M.D.B.D.C.); (S.M.)
| | - Roberta Galatola
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (F.V.); (V.R.); (M.K.); (E.G.); (M.D.B.D.C.); (S.M.)
- Correspondence: ; Tel.: +39-0817463560; Fax: +39-0815457081
| | - Valeria Romeo
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (F.V.); (V.R.); (M.K.); (E.G.); (M.D.B.D.C.); (S.M.)
| | - Raffaele Liuzzi
- Institute of Biostructures and Bioimaging, The National Research Council (CNR), 80131 Naples, Italy; (R.L.); (P.P.M.)
| | - Pier Paolo Mainenti
- Institute of Biostructures and Bioimaging, The National Research Council (CNR), 80131 Naples, Italy; (R.L.); (P.P.M.)
| | - Giovanni Aprea
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (F.V.); (V.R.); (M.K.); (E.G.); (M.D.B.D.C.); (S.M.)
| | - Elia Guadagno
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (F.V.); (V.R.); (M.K.); (E.G.); (M.D.B.D.C.); (S.M.)
| | - Marialaura Del Basso De Caro
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (F.V.); (V.R.); (M.K.); (E.G.); (M.D.B.D.C.); (S.M.)
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (A.S.); (F.V.); (V.R.); (M.K.); (E.G.); (M.D.B.D.C.); (S.M.)
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