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 tomog...

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Autores principales:	Filippo Ceccato, Irene Tizianel, Giacomo Voltan, Gianmarco Maggetto, Isabella Merante Boschin, Emilio Quaia, Filippo Crimì, Carla Scaroni
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	adrenal incidentaloma autonomous cortisol secretion attenuation value computed tomography Hounsfield Unit Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/344fdb278d804d3f9494d6990854d85f
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spelling	oai:doaj.org-article:344fdb278d804d3f9494d6990854d85f2021-12-03T09:09:41ZAttenuation Value in Adrenal Incidentalomas: A Longitudinal Study1664-239210.3389/fendo.2021.794197https://doaj.org/article/344fdb278d804d3f9494d6990854d85f2021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.794197/fullhttps://doaj.org/toc/1664-2392ContextA 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.Filippo CeccatoFilippo CeccatoFilippo CeccatoIrene TizianelIrene TizianelGiacomo VoltanGiacomo VoltanGianmarco MaggettoIsabella Merante BoschinIsabella Merante BoschinEmilio QuaiaEmilio QuaiaFilippo CrimìFilippo CrimìCarla ScaroniCarla ScaroniFrontiers Media S.A.articleadrenal incidentalomaautonomous cortisol secretionattenuation valuecomputed tomographyHounsfield UnitDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	adrenal incidentaloma autonomous cortisol secretion attenuation value computed tomography Hounsfield Unit Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	adrenal incidentaloma autonomous cortisol secretion attenuation value computed tomography Hounsfield Unit Diseases of the endocrine glands. Clinical endocrinology RC648-665 Filippo Ceccato Filippo Ceccato Filippo Ceccato Irene Tizianel Irene Tizianel Giacomo Voltan Giacomo Voltan Gianmarco Maggetto Isabella Merante Boschin Isabella Merante Boschin Emilio Quaia Emilio Quaia Filippo Crimì Filippo Crimì Carla Scaroni Carla Scaroni Attenuation Value in Adrenal Incidentalomas: A Longitudinal Study
description	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.
format	article
author	Filippo Ceccato Filippo Ceccato Filippo Ceccato Irene Tizianel Irene Tizianel Giacomo Voltan Giacomo Voltan Gianmarco Maggetto Isabella Merante Boschin Isabella Merante Boschin Emilio Quaia Emilio Quaia Filippo Crimì Filippo Crimì Carla Scaroni Carla Scaroni
author_facet	Filippo Ceccato Filippo Ceccato Filippo Ceccato Irene Tizianel Irene Tizianel Giacomo Voltan Giacomo Voltan Gianmarco Maggetto Isabella Merante Boschin Isabella Merante Boschin Emilio Quaia Emilio Quaia Filippo Crimì Filippo Crimì Carla Scaroni Carla Scaroni
author_sort	Filippo Ceccato
title	Attenuation Value in Adrenal Incidentalomas: A Longitudinal Study
title_short	Attenuation Value in Adrenal Incidentalomas: A Longitudinal Study
title_full	Attenuation Value in Adrenal Incidentalomas: A Longitudinal Study
title_fullStr	Attenuation Value in Adrenal Incidentalomas: A Longitudinal Study
title_full_unstemmed	Attenuation Value in Adrenal Incidentalomas: A Longitudinal Study
title_sort	attenuation value in adrenal incidentalomas: a longitudinal study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/344fdb278d804d3f9494d6990854d85f
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Attenuation Value in Adrenal Incidentalomas: A Longitudinal Study

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