Adrenocortical carcinoma CT: Difference between revisions

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{{CMG}}; {{AE}} {{AAM}} {{MAD}}
{{CMG}}; {{AE}} {{AAM}} {{MAD}}
==Overview==
==Overview==
Adrenal CT scan may be helpful in the diagnosis of Adrenocortical carcinoma and differentiating it from other diseases, such as [[adrenocortical adenoma]]. Signs such as  
Adrenal CT scan may be helpful in the diagnosis of Adrenocortical carcinoma (ACC) and differentiating it from other diseases, such as [[adrenocortical adenoma]]. Signs such as Internal [[hemorrhage]], [[Calcification|calcifications]], CT density > 10 HU or [[necrosis]] increase the chances of ACC.
==Key CT Findings in adrenocortical carcinoma==
==Key CT Findings in adrenocortical carcinoma==
*[[CT scan]] of the [[abdomen]] is useful for:
*[[CT scan]] of the [[abdomen]] is useful for:
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! Properities
! Properities
! Adrenocortical carcinoma  
! Adrenocortical carcinoma  
! Adrenocortical adenoma  
! [[Adrenocortical adenoma]]
|-  
|-  
|Size                   
|Size                   
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|<4 cm  
|<4 cm  
|-  
|-  
|Necrosis  
|[[Necrosis]]
| +  
| +  
| -  
| -  
|-  
|-  
|Hemorrhage  
|[[Hemorrhage]]
| +  
| +  
| -  
| -  
|-  
|-  
|Calcification  
|[[Calcification]]
| +  
| +  
| -  
| -  
|-  
|-  
| CTdensity
| CT density
|Heterogeneous, >10 HU  
|Heterogeneous, >10 HU  
|Homogeneous, <10 HU  
|Homogeneous, <10 HU  
|-  
|-  
|Chemical-shift MRI  
|[[Chemical shift|Chemical-shift]] [[MRI]]
|Heterogeneous signal drop +/-  
|Heterogeneous signal drop +/-  
|Homogeneous signal drop  
|Homogeneous signal drop  
|-  
|-  
|Chemical-shift contrast enhancement  
|Chemical-shift [[Contrast enhanced CT|contrast enhancement]]
|Heterogeneous, absolute % washout <60%  
|Heterogeneous, absolute % washout <60%  
|Homogeneous, absolute % washout >60%  
|Homogeneous, absolute % washout >60%  
|-  
|-  
|SUV on [18F]FDGPET/CT  
|SUV on [18F]FDG [[PET scan|PET/CT]]
|Adrenal to liver SUV ratio >1.45  
|[[Adrenal gland|Adrenal]] to [[liver]] SUV ratio >1.45  
|Adrenal to liver SUV ratio <1.45  
|[[Adrenal gland|Adrenal]] to [[liver]] SUV ratio <1.45  
|}
|}



Revision as of 14:32, 20 September 2017

Adrenocortical carcinoma Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2] Mohammed Abdelwahed M.D[3]

Overview

Adrenal CT scan may be helpful in the diagnosis of Adrenocortical carcinoma (ACC) and differentiating it from other diseases, such as adrenocortical adenoma. Signs such as Internal hemorrhage, calcifications, CT density > 10 HU or necrosis increase the chances of ACC.

Key CT Findings in adrenocortical carcinoma

Properities Adrenocortical carcinoma Adrenocortical adenoma
Size >4 cm <4 cm
Necrosis + -
Hemorrhage + -
Calcification + -
CT density Heterogeneous, >10 HU Homogeneous, <10 HU
Chemical-shift MRI Heterogeneous signal drop +/- Homogeneous signal drop
Chemical-shift contrast enhancement Heterogeneous, absolute % washout <60% Homogeneous, absolute % washout >60%
SUV on [18F]FDG PET/CT Adrenal to liver SUV ratio >1.45 Adrenal to liver SUV ratio <1.45
Non-contrast CT showing ACC with calcifications, source: Case courtesy of Dr Arshdeep Sidhu, Radiopaedia.org, rID: 22048 ct without
CT angiography shows Case courtesy of Radswiki, Radiopaedia.org, rID: 11176 ct with angio

References

  1. Krebs TL, Wagner BJ (1998). "MR imaging of the adrenal gland: radiologic-pathologic correlation". Radiographics. 18 (6): 1425–40. doi:10.1148/radiographics.18.6.9821192. PMID 9821192.
  2. Fishman EK, Deutch BM, Hartman DS, Goldman SM, Zerhouni EA, Siegelman SS (1987). "Primary adrenocortical carcinoma: CT evaluation with clinical correlation". AJR Am J Roentgenol. 148 (3): 531–5. doi:10.2214/ajr.148.3.531. PMID 3492881.
  3. Egbert N, Elsayes KM, Azar S, Caoili EM (2010). "Computed tomography of adrenocortical carcinoma containing macroscopic fat". Cancer Imaging. 10: 198–200. doi:10.1102/1470-7330.2010.0029. PMC 2999409. PMID 21067996.
  4. Bharwani N, Rockall AG, Sahdev A, Gueorguiev M, Drake W, Grossman AB; et al. (2011). "Adrenocortical carcinoma: the range of appearances on CT and MRI". AJR Am J Roentgenol. 196 (6): W706–14. doi:10.2214/AJR.10.5540. PMID 21606258.