scholarly journals The Application of Dual-phase Enhanced CT Scan in Distinguishing Adrenal Ganglioneuromas From Adrenal Lipid-poor Adenomas

Author(s):  
Huajun Yu ◽  
Jian Wang ◽  
Zhongfeng Niu ◽  
Meihua Shao

Abstract Background:The utility of dual-phase enhanced CT scan in distinguishing ganglioneuromas from lipid-poor adenomas has not been reported. We aimed to prospectively compare CT findings helpful in distinguishing adrenal ganglioneuromas from adrenal lipid-poor adenomas. Methods: We estimated the 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. Results:Significant differences were detected in CT value of unenhanced (CTU), CT value of arterial phase (CTA), CT value of venous phase (CTV), degree of enhancement in arterial phase (DEAP), degree of enhancement in portal venous phase (DEPP), age, tumor size [long diameter (LD), short diameter (SD), mean diameter (MD)], 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 (AUC) of CTU, CTA and CTV 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 CTU, CTA, and CTV, 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 between ganglioneuromas and lipid-poor adenomas.Conclusion: 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.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yong Zhu ◽  
Yingfan Mao ◽  
Jun Chen ◽  
Yudong Qiu ◽  
Yue Guan ◽  
...  

AbstractTo explore the value of contrast-enhanced CT texture analysis in predicting isocitrate dehydrogenase (IDH) mutation status of intrahepatic cholangiocarcinomas (ICCs). Institutional review board approved this study. Contrast-enhanced CT images of 138 ICC patients (21 with IDH mutation and 117 without IDH mutation) were retrospectively reviewed. Texture analysis was performed for each lesion and compared between ICCs with and without IDH mutation. All textural features in each phase and combinations of textural features (p < 0.05) by Mann–Whitney U tests were separately used to train multiple support vector machine (SVM) classifiers. The classification generalizability and performance were evaluated using a tenfold cross-validation scheme. Among plain, arterial phase (AP), portal venous phase (VP), equilibrium phase (EP) and Sig classifiers, VP classifier showed the highest accuracy of 0.863 (sensitivity, 0.727; specificity, 0.885), with a mean area under the receiver operating characteristic curve of 0.813 in predicting IDH mutation in validation cohort. Texture features of CT images in portal venous phase could predict IDH mutation status of ICCs with SVM classifier preoperatively.


Heart ◽  
2018 ◽  
Vol 105 (4) ◽  
pp. 275-322 ◽  
Author(s):  
Rory O’Donohoe ◽  
Samantha Fitzsimmons ◽  
Timothy J C Bryant

Clinical introductionA woman in her 30s presented to the emergency department with sudden-onset abdominal pain with hypotension and tachycardia. She gave a history of congenital heart disease for which she had previously undergone multiple operations. On examination she demonstrated right upper quadrant tenderness. She underwent an urgent multiphase CT (figure 1A–C).Figure 1(A) Arterial phase coronal CT. (B) Arterial phase axial CT. (C) Portal venous phase axial CT.QuestionWhat is the underlying liver pathology?Hepatocellular adenomaCholangiocarcinomaHepatocellular carcinomaFocal nodular hyperplasiaHepatoblastoma


Author(s):  
Christine U. Lee ◽  
James F. Glockner

37-year-old woman with a history of recurrent pancreatitis and abdominal pain Arterial phase (Figure 5.6.1A), portal venous phase (Figure 5.6.1B), equilibrium phase (Figure 5.6.1C), and 8-minute delayed phase (Figure 5.6.1D) postgadolinium 3D SPGR images show multiple splenic lesions that are initially hypoenhancing relative to adjacent spleen and become hyperintense on delayed images....


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hui Hua ◽  
Yuanxiang Gao ◽  
Jizheng Lin ◽  
Feng Hou ◽  
Jun wei Wang ◽  
...  

Objective. This study was performed to assess the value of quantitative analysis of enhanced computed tomography (CT) values in the differential diagnosis of bladder cancer and cystitis glandularis (CG). Methods. Eighty patients with bladder masses (39 with CG and 41 with bladder cancer) who underwent enhanced CT were retrospectively reviewed. The CT enhancement values of the lesion and normal bladder wall in the arterial phase, venous phase, and delayed phase were measured. The relative enhancement CT values (relative enhancement CT value=enhancement CT value of lesion−enhancement CT value of normal bladder) in the arterial phase, venous phase, and delayed phase were also calculated. The pathological results were used as the gold standard, and the area under the curve (AUC), sensitivity, and specificity were calculated for the six groups of quantitative indicators (enhanced CT values and relative enhanced CT values of CG and bladder cancer in the arterial, venous, and delayed phases). We performed the leave-group-out cross-validation method to validate the accuracy, AUC, sensitivity, and specificity. The differences in accuracy, AUC, sensitivity, and specificity among the six groups of quantitative indicators were compared by the t-test. Results. In a combined analysis of the AUC, sensitivity, and specificity performance, the best indicator was the arterial-phase relative enhancement CT value with a cut-off of 25.85 HU (AUC, 0.966; sensitivity, 95.1%; specificity, 92.3%). We used the 100-times leave-group-out cross-validation method to validate the accuracy, AUC, sensitivity, and specificity. Arterial-phase relative enhancement CT values showed the highest AUC and accuracy among the six groups, with statistical significance (P<0.05). Conclusion. Quantitative analysis of enhanced CT is of great clinical value in the differential diagnosis of CG and bladder cancer.


2020 ◽  
Vol 6 (1) ◽  
pp. 20180125
Author(s):  
Chee-Wai Cheng ◽  
Mitchell Machtay ◽  
Jennifer Dorth ◽  
Olga Sergeeva ◽  
Hangsheng Xia ◽  
...  

Hepatocellular carcinoma (HCC) has become one of the leading causes of cancer death worldwide. There has been anecdotal report regarding the effectiveness of proton beam treatment for HCC. In this pre-clinical investigation, the woodchuck model of viral hepatitis infection-induced HCC was used for proton beam treatment experiment. The radiopaque fiducial markers that are biodegradable were injected around the tumor under ultrasound guidance to facilitate positioning in sequential treatments. An α cradle mode was used to ensure reproducibility of animal positioning on the treatment couch. A CT scan was performed first for contouring by a radiation oncologist. The CT data set with contours was then exported for dose planning. Three fractionations, each 750 CcGyE, were applied every other day with a Mevion S250 passive scattering proton therapy system. Multiphase contrast-enhanced CT scans were performed after the treatment and at later times for follow-ups. 3 weeks post-treatment, shrinking of the HCC nodule was detected and constituted to a partial response (30% reduction along the long axis). By week nine after treatment, the nodule disappeared during the arterial phase of multiphase contrast-enhanced CT scan. Pathological evaluation corroborated with this imaging response. A delayed, but complete imaging response to proton beam treatment applied to HCC was achieved with this unique and clinically relevant animal model of HCC.


2013 ◽  
Vol 26 (6) ◽  
pp. 1082-1090 ◽  
Author(s):  
Matthias Hammon ◽  
Alexander Cavallaro ◽  
Marius Erdt ◽  
Peter Dankerl ◽  
Matthias Kirschner ◽  
...  

2021 ◽  
Vol 18 (2) ◽  
Author(s):  
Sara Besharat ◽  
Fatemehsadat Rahimi ◽  
Siamak Afaghi ◽  
Farzad Esmaeili Tarki ◽  
Fatemeh Pourmotahari ◽  
...  

Background: Coronavirus disease 2019 (COVID-19) has several chest computed tomography (CT) characteristics, which are important for the early management of this disease, because viral detection via RT-PCR can be time-consuming, resulting in a delayed pneumonia diagnosis. The Radiological Society of North America (RSNA) proposed a reporting language for CT findings related to COVID-19 and defined four CT categories: typical, indeterminate, atypical, and negative. Objectives: To retrospectively evaluate the chest CT characteristics of patients with COVID-19 pneumonia. Patients and Methods: A total of 115 hospitalized laboratory-verified COVID-19 cases, underdoing chest CT scan, were included in this study from April 30 to May 15, 2020. Of 115 cases, 53 were discharged from the hospital, and 62 expired. The initial clinical features and chest CT scans were assessed for the type, pattern, distribution, and frequency of lesions. Moreover, the findings were compared between ward-hospitalized, ICU-admitted, and non-surviving (expired) patients. Results: Of four CT categories, typical CT findings for COVID-19 were more frequent in the expired group (77.4%), compared to the ward-admitted (44.8%) and ICU-admitted (70.8%) groups (P = 0.017). However, no significant difference was observed in the prevalence of intermediate or atypical CT findings between the groups. Negative CT scans for the diagnosis of COVID-19 were significantly fewer in the expired group (0%) as compared to the ward-admitted (10.3%) and ICU-admitted (8.3%) groups (P = 0.0180). Also, the mean number of involved lung lobes and segments was significantly higher in the expired group compared to the other two groups (P = 0.032 and 0.010, respectively). The right upper lobe involvement, right middle lobe involvement, bilateral involvement, central lesion, air bronchogram, and pleural effusion were among CT scan findings with a significantly higher prevalence in non-surviving cases (P < 0.0001, 0.047, 0.01, 0.036, 0.038, and 0.047, respectively). Conclusion: The increased number of involved lung lobes and segments, bilateral and central distribution patterns, air bronchogram, and severe pleural effusion in the initial chest CT scan can be related to the increased severity and poor prognosis of COVID-19.


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