CT Characteristics of Pheochromocytoma: Relevance for the Evaluation of Adrenal Incidentaloma.
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Canu Letizia, Van Hemert Janna A W, Kerstens Michiel N, Hartman Robert P, Khanna Aakanksha, Kraljevic Ivana, Kastelan Darko, Badiu Corin, Ambroziak Urszula, Tabarin Antoine, Haissaguerre Magalie, Buitenwerf Edward, Visser Anneke, Mannelli Massimo, Arlt Wiebke, Chortis Vasileios, Bourdeau Isabelle, Gagnon Nadia, Buchy Marie, Borson-Chazot Francoise, Deutschbein Timo, Fassnacht Martin, Hubalewska-Dydejczyk Alicja, Motyka Marcin, Rzepka Ewelina, Casey Ruth T, Challis Benjamin G, Quinkler Marcus, Vroonen Laurent, Spyroglou Ariadni, Beuschlein Felix, Lamas Cristina, Young William F, Bancos Irina, Timmers Henri J L M
Аннотация
AIM: To determine the proportion of PCCs with ACA-like attenuation or contrast washout on CT.
METHODS: For this multicenter retrospective study, two central investigators independently analyzed the CT reports of 533 patients with 548 histologically confirmed PCCs. Data on tumor size, unenhanced Hounsfield units (HU), absolute percentage washout (APW), and relative percentage washout (RPW) were collected in addition to clinical parameters.
RESULTS: Among the 376 PCCs for which unenhanced attenuation data were available, 374 had an attenuation of >10 HU (99.5%). In the two exceptions (0.5%), unenhanced attenuation was exactly 10 HU, which lies just within the range of ≤10 HU that would suggest a diagnosis of ACA. Of 76 PCCs with unenhanced HU > 10 and available washout data, 22 (28.9%) had a high APW and/or RPW, suggestive of ACA.
CONCLUSION: Based on the lack of PCCs with an unenhanced attenuation of <10 HU and the low proportion (0.5%) of PCCs with an attenuation of 10 HU, it seems reasonable to abstain from biochemical testing for PCC in AIs with an unenhanced attenuation of ≤10 HU. The assessment of contrast washout, however, is unreliable for ruling out PCC.