Publication:
Combining washout and noncontrast data from adrenal protocol CT: improving diagnostic performance

dc.contributor.coauthorNg, Chaan S.
dc.contributor.coauthorWei, Wei
dc.contributor.coauthorGhosh, Payel
dc.contributor.coauthorLi, Xiao
dc.contributor.coauthorGrubbs, Elizabeth G.
dc.contributor.coauthorPerrier, Nancy A.
dc.contributor.coauthorPrieto, Victor G.
dc.contributor.coauthorLee, Jeffrey E.
dc.contributor.coauthorHobbs, Brian P.
dc.contributor.kuauthorAltınmakas, Emre
dc.contributor.kuprofileOther
dc.contributor.yokid143682
dc.date.accessioned2024-11-09T23:39:25Z
dc.date.issued2018
dc.description.abstractRationale and Objectives: To determine if combination of washout and noncontrast data from delayed adrenal computed tomography (CT) improves diagnostic performance, and demonstration of an optimizing analytical framework. Materials and Methods: This retrospective study consisted of 97 adrenal lesions, in 96 patients, with pathologically proven adrenal lesions (75 benign; 22 malignant), who had undergone noncontrast, portal- and approximate 15-minute delayed-phase CT. Lesion CT attenuations (Hounsfield units [HU]) during each phase, and “absolute” and “relative” percent enhancement washouts (APEW and RPEW) were assessed. The optimum combination of sequential parameters and thresholds was determined by recursive partitioning analysis; resultant diagnostic performance was compared to commonly applied single-parameter criteria for malignancy (noncontrast > 10 HU, APEW < 60%, RPEW < 40%). Results: The above single-parameter criteria yielded sensitivities, specificities, and accuracies for malignancy of 100.0%, 41.3%, and 54.6%; 97.9%, 61.3%, and 69.1%; and 96.6%, 74.7%, and 78.4%, respectively. Recursive partitioning analysis identified noncontrast ≥24.75 HU, with subsequent APEW ≤63.49%, as the optimum sequential parameter-threshold combination, which yielded increased sensitivity, specificity, and accuracy of 100.0%, 85.3%, and 90.7%, respectively. Discrimination using the combined sequential classifier yielded statistically significant improvements in accuracy when compared to the above conventional single-parameter criteria (all P ≤.039). Conclusion: Sequential application of noncontrast and washout criteria from delayed contrast-enhanced adrenal CT can improve diagnostic performance beyond that of commonly applied single-parameter criteria. Validation of the sequential ordering and refinement of the specific threshold values warrant further study.
dc.description.indexedbyWoS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue7
dc.description.openaccessYES
dc.description.publisherscopeInternational
dc.description.volume25
dc.identifier.doi10.1016/j.acra.2017.12.005
dc.identifier.issn1076-6332
dc.identifier.linkhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85041627600&doi=10.1016%2fj.acra.2017.12.005&partnerID=40&md5=071ac4221cbc7fc3ffb474ec279ee670
dc.identifier.scopus2-s2.0-85041627600
dc.identifier.urihttp://dx.doi.org/10.1016/j.acra.2017.12.005
dc.identifier.urihttps://hdl.handle.net/20.500.14288/13114
dc.keywordsAdrenal
dc.keywordsAdrenal tumors
dc.keywordsDelayed washout CT
dc.keywordsCharacterization
dc.keywordsRecursive partitioning analysis
dc.languageEnglish
dc.publisherElsevier
dc.sourceAcademic Radiology
dc.subjectRadiology
dc.subjectNuclear medicine
dc.subjectMedical imaging
dc.titleCombining washout and noncontrast data from adrenal protocol CT: improving diagnostic performance
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.authorid0000-0002-0727-9230
local.contributor.kuauthorAltınmakas, Emre
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit2School of Medicine

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