Prognostic significance of adrenal gland morphology at CT in patients with three common malignancies Journal Article


Authors: Meehan, C. P.; Fuqua, J. L. 3rd; Reiner, A. S.; Moskowitz, C. S.; Schwartz, L. H.; Panicek, D. M.
Article Title: Prognostic significance of adrenal gland morphology at CT in patients with three common malignancies
Abstract: Objectives: To determine whether minor alterations in adrenal gland morphology at baseline CT in three common cancers indicate early metastasis. Methods: 689 patients (237 with lung cancer, 228 with breast cancer, 224 with melanoma) underwent baseline and follow-up CTs that included the adrenals. Two readers independently scored each adrenal at baseline CT as normal, smoothly enlarged, nodular or mass-containing. Adrenals containing a mass > 10 mm were excluded. The appearance of each adrenal on the latest available CT was assessed for change since baseline. Cox models were used to assess the association between adrenal morphology at initial CT and subsequent development of adrenal metastasis (defined as new mass > 10 mm, corroborated by follow-up imaging). K statistics were calculated to assess inter-reader agreement. Results: Initial and follow-up CT evaluations were recorded for 1317 adrenals (median follow-up, 18.6 months). At initial CT, Readers 1 and 2 interpreted 1242 and 1230 adrenals as normal, 40 and 57 as smoothly enlarged, 29 and 25 as nodular, and 6 and 5 as containing masses ≤ 10 mm, respectively. k-values were 0.52 (moderate) at initial CT and 0.70 (substantial) at follow-up. The hazard ratio for developing a metastasis at follow-up CT given an abnormal adrenal assessment at baseline was 0.7 [95% confidence interval (CI) 0.2-2.1; p=0.47] for Reader 1, and 2.0 (95% CI 0.8-4.7; p=0.12) for Reader 2. Conclusion: Minor morphological abnormalities of adrenals at initial CT did not represent early adrenal metastasis in most patients in this population. © 2012 The British Institute of Radiology.
Keywords: adult; aged; aged, 80 and over; middle aged; retrospective studies; major clinical study; disease course; follow up; melanoma; computer assisted tomography; breast cancer; skin neoplasms; tumor volume; lung neoplasms; lung cancer; tomography, x-ray computed; breast neoplasms; carcinoma; contrast medium; adrenal gland neoplasms; adrenal metastasis
Journal Title: British Journal of Radiology
Volume: 85
Issue: 1014
ISSN: 0007-1285
Publisher: British Institute of Radiology  
Date Published: 2012-06-01
Start Page: 807
End Page: 812
Language: English
DOI: 10.1259/bjr/69444644
PROVIDER: scopus
PUBMED: 21750128
PMCID: PMC3474113
DOI/URL:
Notes: --- - "Export Date: 2 July 2012" - "CODEN: BJRAA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Anne S Reiner
    115 Reiner
  2. David M Panicek
    115 Panicek
  3. Lawrence H Schwartz
    275 Schwartz
  4. Conor Paul Meehan
    2 Meehan
  5. Chaya S. Moskowitz
    170 Moskowitz