The application of dual-phase enhanced CT scan in distinguishing adrenal ganglioneuromas from adrenal lipid-poor adenomas

Abstract

Background

The utility of dual-phase enhanced computerized tomography (CT) scan in distinguishing adrenal ganglioneuromas from lipid-poor adenomas has not been reported. We aimed to retrospectively compare dual-phase enhanced CT findings which were helpful in distinguishing adrenal ganglioneuromas from adrenal lipid-poor adenomas.

Methods

We estimated the dual-phase enhanced CT findings of 258 adrenal masses (42 ganglioneuromas, 216 lipid-poor adenomas) in 258 patients from July 2008 to July 2020 with ganglioneuromas and July 2016 to July 2020 with lipid-poor adenomas. The CT features between ganglioneuromas and lipid-poor adenomas were compared using independent two-sample t test, Mann–Whitney test, and ROC analysis.

Results

Significant differences were detected in CT value of unenhanced (CT_U), CT value of arterial phase (CT_A), CT value of venous phase (CT_V), degree of enhancement in arterial phase, degree of enhancement in portal venous phase, age, tumor size [longest dimension, shortest dimension, mean dimension], shape, calcification between the ganglioneuroma and lipid-poor adenoma groups (P < 0.05). The results of receiver operating characteristics (ROC) analyses showed that areas under ROC curves of CT_U, CT_A and CT_V were 0.713, 0.878, and 0.914, respectively. When the cut-off values were set at 22.5 HU, 51.5 HU, and 53.5 HU for CT_U, CT_A, and CT_V, respectively, the three parameters had a sensitivity of 46.8%, 67.6%, and 88.0% and a specificity of 100%, 100%, and 88.1% in distinguishing ganglioneuromas from lipid-poor adenomas.

Conclusions

Dual-phase enhanced abdominal CT can exhibit some of the primary imaging characteristics of ganglioneuromas and lipid-poor adenomas used to distinguish between these two entities.