CT characteristics of pheochromocytoma - Relevance for the evaluation of adrenal incidentaloma

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CT characteristics of pheochromocytoma - Relevance for the evaluation of adrenal incidentaloma. / Canu, Letizia; Van Hemert, Janna A W; Kerstens, Michiel; Hartman, Robert; 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, H Alicja; Motyka, Marcin; Rzepka, Wewlina; Casey, Ruth T.; Challis, Benjamin; Quinkler, Marcus; Vroonen, Laurent; Spyroglou, Ariadni; Beuschlein, Felix; Lamas, Cristina; Young, William F; Bancos, Irina; Timmers, Henri J.

In: Journal of Clinical Endocrinology and Metabolism, 31.10.2018.

Research output: Contribution to journalArticlepeer-review

Harvard

Canu, L, Van Hemert, JAW, Kerstens, M, Hartman, R, Khanna, A, Kraljevic, I, Kastelan, D, Badiu, C, Ambroziak, U, Tabarin, A, Haissaguerre, M, Buitenwerf, E, Visser, A, Mannelli, M, Arlt, W, Chortis, V, Bourdeau, I, Gagnon, N, Buchy, M, Borson-Chazot, F, Deutschbein, T, Fassnacht, M, Hubalewska Dydejczyk, HA, Motyka, M, Rzepka, W, Casey, RT, Challis, B, Quinkler, M, Vroonen, L, Spyroglou, A, Beuschlein, F, Lamas, C, Young, WF, Bancos, I & Timmers, HJ 2018, 'CT characteristics of pheochromocytoma - Relevance for the evaluation of adrenal incidentaloma', Journal of Clinical Endocrinology and Metabolism. https://doi.org/10.1210/jc.2018-01532

APA

Canu, L., Van Hemert, J. A. W., Kerstens, M., Hartman, R., Khanna, A., Kraljevic, I., Kastelan, D., Badiu, C., Ambroziak, U., Tabarin, A., Haissaguerre, M., Buitenwerf, E., Visser, A., Mannelli, M., Arlt, W., Chortis, V., Bourdeau, I., Gagnon, N., Buchy, M., ... Timmers, H. J. (2018). CT characteristics of pheochromocytoma - Relevance for the evaluation of adrenal incidentaloma. Journal of Clinical Endocrinology and Metabolism. https://doi.org/10.1210/jc.2018-01532

Vancouver

Author

Canu, Letizia ; Van Hemert, Janna A W ; Kerstens, Michiel ; Hartman, Robert ; 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, H Alicja ; Motyka, Marcin ; Rzepka, Wewlina ; Casey, Ruth T. ; Challis, Benjamin ; Quinkler, Marcus ; Vroonen, Laurent ; Spyroglou, Ariadni ; Beuschlein, Felix ; Lamas, Cristina ; Young, William F ; Bancos, Irina ; Timmers, Henri J. / CT characteristics of pheochromocytoma - Relevance for the evaluation of adrenal incidentaloma. In: Journal of Clinical Endocrinology and Metabolism. 2018.

Bibtex

@article{ea79cd822cc145fd9d0d5da3cfaba440,
title = "CT characteristics of pheochromocytoma - Relevance for the evaluation of adrenal incidentaloma",
abstract = "Background Up to 7% of all adrenal incidentalomas (AIs) are pheochromocytomas (PCCs). In the evaluation of AI, it is generally recommended to exclude PCC by measurement plasma free or 24h urinary fractionated metanephrines. However, recent studies suggest to abstain from biochemical exclusion of PCC in cases of lesions with computed tomography (CT) characteristics of an adrenocortical adenoma (ACA). 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 besides 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 ≤10 HU. The assessment of contrast washout, however, is unreliable to rule out PCC.",
author = "Letizia Canu and {Van Hemert}, {Janna A W} and Michiel Kerstens and Robert Hartman and Aakanksha Khanna and Ivana Kraljevic and Darko Kastelan and Corin Badiu and Urszula Ambroziak and Antoine Tabarin and Magalie Haissaguerre and Edward Buitenwerf and Anneke Visser and Massimo Mannelli and Wiebke Arlt and Vasileios Chortis and Isabelle Bourdeau and Nadia Gagnon and Marie Buchy and Francoise Borson-Chazot and Timo Deutschbein and Martin Fassnacht and {Hubalewska Dydejczyk}, {H Alicja} and Marcin Motyka and Wewlina Rzepka and Casey, {Ruth T.} and Benjamin Challis and Marcus Quinkler and Laurent Vroonen and Ariadni Spyroglou and Felix Beuschlein and Cristina Lamas and Young, {William F} and Irina Bancos and Timmers, {Henri J}",
year = "2018",
month = oct,
day = "31",
doi = "10.1210/jc.2018-01532",
language = "English",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "Endocrine Society",

}

RIS

TY - JOUR

T1 - CT characteristics of pheochromocytoma - Relevance for the evaluation of adrenal incidentaloma

AU - Canu, Letizia

AU - Van Hemert, Janna A W

AU - Kerstens, Michiel

AU - Hartman, Robert

AU - Khanna, Aakanksha

AU - Kraljevic, Ivana

AU - Kastelan, Darko

AU - Badiu, Corin

AU - Ambroziak, Urszula

AU - Tabarin, Antoine

AU - Haissaguerre, Magalie

AU - Buitenwerf, Edward

AU - Visser, Anneke

AU - Mannelli, Massimo

AU - Arlt, Wiebke

AU - Chortis, Vasileios

AU - Bourdeau, Isabelle

AU - Gagnon, Nadia

AU - Buchy, Marie

AU - Borson-Chazot, Francoise

AU - Deutschbein, Timo

AU - Fassnacht, Martin

AU - Hubalewska Dydejczyk, H Alicja

AU - Motyka, Marcin

AU - Rzepka, Wewlina

AU - Casey, Ruth T.

AU - Challis, Benjamin

AU - Quinkler, Marcus

AU - Vroonen, Laurent

AU - Spyroglou, Ariadni

AU - Beuschlein, Felix

AU - Lamas, Cristina

AU - Young, William F

AU - Bancos, Irina

AU - Timmers, Henri J

PY - 2018/10/31

Y1 - 2018/10/31

N2 - Background Up to 7% of all adrenal incidentalomas (AIs) are pheochromocytomas (PCCs). In the evaluation of AI, it is generally recommended to exclude PCC by measurement plasma free or 24h urinary fractionated metanephrines. However, recent studies suggest to abstain from biochemical exclusion of PCC in cases of lesions with computed tomography (CT) characteristics of an adrenocortical adenoma (ACA). 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 besides 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 ≤10 HU. The assessment of contrast washout, however, is unreliable to rule out PCC.

AB - Background Up to 7% of all adrenal incidentalomas (AIs) are pheochromocytomas (PCCs). In the evaluation of AI, it is generally recommended to exclude PCC by measurement plasma free or 24h urinary fractionated metanephrines. However, recent studies suggest to abstain from biochemical exclusion of PCC in cases of lesions with computed tomography (CT) characteristics of an adrenocortical adenoma (ACA). 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 besides 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 ≤10 HU. The assessment of contrast washout, however, is unreliable to rule out PCC.

U2 - 10.1210/jc.2018-01532

DO - 10.1210/jc.2018-01532

M3 - Article

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

ER -