MRI as an alternative to CT-guided biopsy of adrenal masses in patients with lung cancer Journal Article

Authors: Schwartz, L. H.; Ginsberg, M. S.; Burt, M. E.; Brown, K. T.; Getrajdman, G. I.; Panicek, D. M.
Article Title: MRI as an alternative to CT-guided biopsy of adrenal masses in patients with lung cancer
Abstract: Background. This study was performed to assess chemical shift magnetic resonance imaging (CSMRI) for characterizing adrenal masses in patients with lung cancer, and to compare charges associated with two algorithms for assessing adrenal masses in these patients. Methods. Forty-two patients with lung cancer underwent both CSMRI (using in-phase and opposed-phase gradient echo images) and computed tomography-guided percutaneous biopsy of adrenal masses. Adrenal-to-spleen signal intensity ratios on the opposed-phase images were correlated with histopathologic results. The normalized charges for two algorithms were compared. In algorithm A, computed tomography-guided biopsy is used first to evaluate an adrenal mass; in algorithm B, CSMRI is used first, followed by computed tomography guided biopsy only if CSMRI findings are not diagnostic of adenoma. Results. Biopsy showed 24 (57%) adrenal adenomas and 18 (43%) metastases. Chemical shift magnetic resonance imaging was 96% sensitive for adenoma and 100% specific. The average normalized charges associated with algorithm A were $1,905 per patient versus $1,890 with algorithm B. Conclusions. Initial use of CSMRI in evaluating an adrenal mass in lung cancer patients can obviate biopsy in 55% of patients, and its charges are similar to those for performing computed tomography-guided biopsy in all patients.
Keywords: adult; clinical article; controlled study; human tissue; aged; aged, 80 and over; middle aged; carcinoma, squamous cell; conference paper; magnetic resonance imaging; sensitivity and specificity; adenocarcinoma; computer assisted tomography; carcinoma, non-small-cell lung; lung neoplasms; lung cancer; tomography, x-ray computed; algorithms; biopsy; cost effectiveness analysis; adenoma; lung biopsy; neoplasms, multiple primary; percutaneous biopsy; adrenal tumor; adrenal gland neoplasms; proton nuclear magnetic resonance; adrenal metastasis; carcinoma, adenosquamous; humans; human; male; female; priority journal
Journal Title: Annals of Thoracic Surgery
Volume: 65
Issue: 1
ISSN: 0003-4975
Publisher: Elsevier Science, Inc.  
Date Published: 1998-01-01
Start Page: 193
End Page: 197
Language: English
DOI: 10.1016/s0003-4975(97)01038-2
PUBMED: 9456116
PROVIDER: scopus
Notes: Conference Paper -- Export Date: 12 December 2016 -- Source: Scopus
Citation Impact
MSK Authors
  1. David M Panicek
    131 Panicek
  2. Michelle S Ginsberg
    177 Ginsberg
  3. Lawrence H Schwartz
    282 Schwartz
  4. Karen T Brown
    171 Brown
  5. Michael E. Burt
    182 Burt