Quantitative imaging in medicine and surgery · 2025
Maximum diameter of carotid body tumor as an independent risk factor for a GAPP score of ≥5: an ultrasound study.
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Li Wenxin, Ma Shumei, Zheng Xiaozhi
Аннотация
BACKGROUND: Grading system for adrenal phaeochromocytoma and paraganglioma (GAPP) is a scoring system used to predict metastatic potential in carotid body tumor (CBT). This study aimed to determine whether ultrasonic parameters are risk factors for a greater GAPP score in CBT.
METHODS: A total of 68 patients (74 CBTs) underwent CBT surgery with preoperative evaluation of CBT size and perfusion using ultrasound (US). GAPP score was determined.
RESULTS: CBTs in patients with a GAPP score of ≥5 (Group 2, n=31) were significantly larger than those with a GAPP score of <5 (Group 1, n=37) (P<0.05). More intraoperative blood loss (IBL) was observed in Group 2 than in Group 1 (P<0.05). In a subgroup of 10 patients who underwent contrast-enhanced US (CEUS), there were no differences between the patients with a GAPP score of ≥5 (n=3) and those with a GAPP score of <5 (n=7) according to the enhancement pattern and quantitative perfusion parameters (P>0.05). Multivariate logistic regression analysis revealed that the maximum diameter of CBT [Dmax; odds ratio (OR) =1.693; 95% confidence interval (CI): 1.106-2.592; P=0.015] was the independent risk factor for a GAPP score of ≥5 in patients with CBT. Receiver operating characteristic (ROC) curve analysis showed that the Dmax had a certain ability to predict a GAPP score of ≥5 [area under the ROC curve (AUC) =0.677, 95% CI: 0.561-0.815; cutoff value, 1.8 cm; sensitivity, 100.00%; specificity, 40.54%].
CONCLUSIONS: The Dmax is an independent risk factor for a GAPP score of 5 or greater in patients with CBT.
METHODS: A total of 68 patients (74 CBTs) underwent CBT surgery with preoperative evaluation of CBT size and perfusion using ultrasound (US). GAPP score was determined.
RESULTS: CBTs in patients with a GAPP score of ≥5 (Group 2, n=31) were significantly larger than those with a GAPP score of <5 (Group 1, n=37) (P<0.05). More intraoperative blood loss (IBL) was observed in Group 2 than in Group 1 (P<0.05). In a subgroup of 10 patients who underwent contrast-enhanced US (CEUS), there were no differences between the patients with a GAPP score of ≥5 (n=3) and those with a GAPP score of <5 (n=7) according to the enhancement pattern and quantitative perfusion parameters (P>0.05). Multivariate logistic regression analysis revealed that the maximum diameter of CBT [Dmax; odds ratio (OR) =1.693; 95% confidence interval (CI): 1.106-2.592; P=0.015] was the independent risk factor for a GAPP score of ≥5 in patients with CBT. Receiver operating characteristic (ROC) curve analysis showed that the Dmax had a certain ability to predict a GAPP score of ≥5 [area under the ROC curve (AUC) =0.677, 95% CI: 0.561-0.815; cutoff value, 1.8 cm; sensitivity, 100.00%; specificity, 40.54%].
CONCLUSIONS: The Dmax is an independent risk factor for a GAPP score of 5 or greater in patients with CBT.