Attenuation Value in Adrenal Incidentalomas: A Longitudinal Study

ContextA tendency to grow has been reported in adrenal incidentalomas. However, long-term data regarding attenuation value, a measure of lipid content, are not available.AimThis study aims to collect radiological data (diameter in mm and attenuation value in Hounsfield units, HU) with computed tomography (CT) in adrenal incidentalomas, in order to compare baseline characteristics with the last follow-up imaging.DesignThis is a longitudinal study which included patients with a new diagnosis of adrenal incidentaloma, evaluated from January 2002 to June 2020.SettingReferral University-Hospital center.PatientsTwo hundred seventy-seven patients with 355 different cortical adenomas (baseline group) were evaluated at the first outpatient visit; the follow-up cohort consists of 181 patients with 234 adenomas (12–175 months after baseline). Inclusion criteria were conservative management and radiological features able to minimize malignancy or risk of progression.Main Outcome MeasureCT modification according to endocrine function: autonomous cortisol secretion (ACS) if cortisol >50 nmol/L after 1-mg dexamethasone test (DST).ResultsAt baseline CT, mean diameter was 18.7 mm and attenuation value was 0.8 HU (higher in ACS, 66 cases >10 HU), without modification in early imaging (12–36 months). The size increased over time (r = 0.289), achieving the largest differences after at least 60 months of follow-up (mean diameter, +2 mm; attenuation value, −4 HU), combined with a reduction in the attenuation value (r = −0.195, especially in patients with ACS). Lipid-poor adenomas (>10 HU) presented a reduced cortisol suppression after 1-mg DST, an increase in size and the largest decrease in attenuation value during follow-up. Univariate analysis confirmed that larger adenomas presented reduced suppression after DST and increase in size during follow-up.ConclusionsGrowth is clinically modest in adrenal incidentaloma: the first follow-up CT 5 years after baseline is a reasonable choice, especially in ACS. Mean density is increased in patients with ACS and overt hypercortisolism. Mean density reduces during follow-up in all adrenal adenomas, suggesting an increase in lipid content, especially in those with ACS.

Role of multidetector ct in quantitative enhancement- washout analysis of solid renal masses

Background Enhancement washout technique in solid renal masses using multidetector computed tomography (MDCT) can differentiate different type of lesions. 99 Patients who are presenting with suspected renal masses or renal tumour for staging are included in this study. CT examination are carried out at urology and nephrology centre using MDCT. The attenuation values (Hounsfield Unit) will be assesed for each lesion on the pre enhanced, corticomedullary, nephrographic and delayed phases. Washout ratio will be calculated for each phase of enhancement in comparison to the unenhanced attenuation value. The characteristics of enhancement-washout will be correlated with the final histopathological diagnosis. Results Early enhancement and washout pattern was noted in 54 renal lesions (54.5%) representing 4 types of renal lesions; Oncocytoma (n = 13), clear cell renal cell carcinoma (n = 16), Chromophobe renal cell carcinoma (n = 15) and unclassified renal cell carcinoma (n = 10).Prolonged enhancement pattern was noted 45 lesions (45.4%); PRCC (n = 14), 10 case of lipid poor AML (n = 10), metanephric adenoma (n = 10) and Xp11 RCC (n = 11). High pre-contrast attenuation was noted in Xp 11RCC showing attenuation value 41.7 ± 6.823HU. The highest CMP values were noted in CCRCC (151.9 ± 20.4) followed by oncocytomas (137.6 ± 19.15HU) and then CHRCC (123.6 ± 16.6 HU)while the lowest values were noted in Metanephric adenoma)57.1 ± 17.4HU)and followed by PRCC (59.9 ± 4.8)and followed by lipid poor AML (79.17 ± 13.666) and RCC unclassified (89.06 ± 18.1). Conclusions Four-phase MDCT (the unenhanced, corticomedullary, nephrographic, and excretory phases) evaluate role of MDCT in differentiation of solid renal masses.

Wettability and sound absorption of graphene oxide doped polymer hydrogel

In this paper, we introduce a nanocomposite as a humidity-sensitive sound absorber. The nanocomposites were prepared using hydrogel polymer (HP) as a matrix and graphene oxide (GO) as a filler. Results show that the surface energy of the nanocomposite is 58.4 mJ m−2, and GO sheets increase the nanocomposite porosity from 2.6716 cm2 g−1 (for HP) up to 3.246 cm2 g−1. In addition, the diameter of nanocomposite pores is 8.5202 nm lower than that of HP (10.274 nm). To study the effect of humidity on the sound absorption, we exposed them to moisture for 30 and 60 min and then measured sound absorption. Results show an absorption peak for the HP at 1022 Hz with an attenuation value of 30%, while the nanocomposite shows two main peaks around 1898 and 3300 Hz. In addition, results show that sound absorption peaks shift to higher frequencies according to humidification time.

Use of Three-Dimensional Printing in Modelling an Anatomical Structure with a High Computed Tomography Attenuation Value: A Feasibility Study

Introduction: Three-dimensional (3D) printing provides an opportunity to develop anthropomorphic computed tomography (CT) phantoms with anatomical and radiological features mimicking a range of patients’ conditions, thus allowing development of individualised, low dose scanning protocols. However, previous studies of 3D printing in CT phantom development could only create anatomical structures using potassium iodide with attenuation values up to 1200 HU which is insufficient to mimic the radiological features of some high attenuation structures such as cortical bone. This study aimed at investigating the feasibility of using 3D printing in modelling cortical bone with a non-iodinated material. Methods: This study had 2 stages. Stage 1 involved a vat photopolymeri-sation 3D printer to directly print cube phantoms with different percentage compositions of calcium phosphate (CP) and resin (approach 1), and approach 2 using a material extrusion 3D printer to develop a cube mould for infilling of the CP with hardener as the phantom. The approach able to create the cube phantom with the CT attenuation value close to that of a tibial mid-diaphysis cortex of a real patient, 1475±205 HU was employed to develop a tibial mid-diaphysis phantom. The mean CT numbers of the cube and tibia phantoms were measured and compared with that of the original CT dataset through unpaired f-test. Results: All phantoms were scanned by CT using a lower extremity scanning protocol. The moulding approach was selected to develop the tibia mid-diaphysis phantom with CT attenuation value, 1434±184 HU which was not statistically significantly different from the one of the original dataset (p = 0.721). Conclusion: This study demonstrates the feasibility to use the material extrusion 3D printer to create a tibial mid-diaphysis mould for infilling of the CP as an anthropomorphic CT phantom and the attenuation value of its cortex matches the real patient’s one.

Graphene Oxide–Polymer Hydrogel: Wettability and Sound Absorption

In this paper, we introduce a nanocomposite as a humidity-sensitive sound absorber. The nanocomposites were prepared using hydrogel polymer (HP) as a matrix and graphene oxide (GO) as a filler. Results show that the surface energy of the nanocomposite is 58.4 mJm-2, and GO sheets increase the nanocomposite porosity from 2.6716 cm2 g-1 (for HP) up to 3.246 cm2 g-1. In addition, the diameter of nanocomposite pores is 8.5202 nm lower than that of HP (10.274 nm). To study the effect of humidity on the sound absorption, we exposed them to moisture for 30 and 60 min and then measured sound absorption. Results show an absorption peak for the HP at 1022 Hz with an attenuation value of 30%, while nanocomposite shows two main peaks around 1898 and 3300 Hz. In addition, results show that sound absorption peaks shift to higher frequency according to humidification time.