Journal
ABDOMINAL RADIOLOGY
Volume 46, Issue 9, Pages 4338-4344Publisher
SPRINGER
DOI: 10.1007/s00261-021-03110-y
Keywords
Adrenal; Nodule; Adenoma; Cortisol; Cushing; Size
Funding
- National Center for Advancing Translational Sciences, National Institutes of Health [UL1 TR001860]
Ask authors/readers for more resources
In patients with adrenal nodules, the length and width of the nodule are the only two variables that significantly differ between nonfunctional nodules and possibly or definitely functional nodules patients. Using a threshold nodule length of 1.5 cm, there is 93.1% sensitivity for predicting possible or definite ACH.
Purpose To determine if CT features of adrenal nodules and of the remainder of the abdomen can predict autonomous cortisol secretion (ACH) in patients with adrenal nodules, and to identify a nodule size threshold below which ACH is unlikely. Methods Retrospective review of adult patients with adrenal nodules who underwent CT of abdomen and 1-mg Dexamethasone suppression test within 1 year of each other. Patients were considered to have no ACH if serum cortisol was <= 1.8 mu g/dL after the 1-mg dexamethasone suppression test and to have possible or definite autonomous cortisol secretion if serum cortisol was > 1.8 mu g/dL. The following CT features were assessed: Adrenal nodule length, nodule width, unenhanced nodule attenuation, contralateral adrenal gland thickness, visceral and subcutaneous adipose tissue area, skeletal muscle area and density, and unenhanced liver attenuation. Results 29 patients had no autonomous cortisol secretion and 29 patients had possible or definite autonomous cortisol secretion. Nodule length and width were the only two variables that significantly differed between patients with nonfunctional nodules and those with possibly or definitely functional nodules. Using a threshold nodule length of 1.5 cm, the sensitivity and specificity for predicting possible or definite autonomous cortisol secretion was 93.1% and 37.9%, respectively. Conclusion Autonomous cortisol secretion in patients with adrenal nodules correlates with increasing nodule size. A nodule length threshold of 1.5 cm provides 93.1% sensitivity for predicting possible or definite ACH based on the 1-mg Dexamethasone suppression test.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available