Discriminative Capacity of CT Volumetry to Identify Autonomous Cortisol Secretion in Incidental Adrenal Adenomas

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dc.catalogadorvzp
dc.contributor.authorOlmos Borzone, Roberto Ignacio
dc.contributor.authorMertens Folch, Nicolas Andres
dc.contributor.authorVaidya, Anand
dc.contributor.authorUslar Nawrath, Thomas Hermann
dc.contributor.authorFernández Walker, Paula Soledad
dc.contributor.authorGuarda Vega, Francisco
dc.contributor.authorZuñiga, Alvaro
dc.contributor.authorSan Francisco Reyes, Ignacio Felipe
dc.contributor.authorHuete Garin, Isidro Alvaro
dc.contributor.authorBaudrand Biggs, Rene Felipe
dc.date.accessioned2024-05-28T20:18:26Z
dc.date.available2024-05-28T20:18:26Z
dc.date.issued2022
dc.description.abstractContext: Incidentally discovered adrenal adenomas are common. Assessment for possible autonomous cortisol excess (ACS) is warranted for all adrenal adenomas, given the association with increased cardiometabolic disease.
dc.description.abstractObjective: To evaluate the discriminatory capacity of 3-dimensional volumetry on computed tomography (CT) to identify ACS.
dc.description.abstractMethods: Two radiologists, blinded to hormonal levels, prospectively analyzed CT images of 149 adult patients with unilateral, incidentally discovered, adrenal adenomas. Diameter and volumetry of the adenoma, volumetry of the contralateral adrenal gland, and the adenoma volume-to-contralateral gland volume (AV/CV) ratio were measured. ACS was defined as cortisol >= 1.8 mcg/dL after 1-mg dexamethasone suppression test (DST) and a morning ACTH <= 15. pg/mL.
dc.description.abstractResults: We observed that ACS was diagnosed in 35 (23.4%) patients. Cortisol post-DST was positively correlated with adenoma diameter and volume, and inversely correlated with contralateral adrenal gland volume. Cortisol post-DST was positively correlated with the AV/CV ratio (r = 0.46, P < 0.001) and ACTH was inversely correlated (r = -0.28, P < 0.001). The AV/CV ratio displayed the highest odds ratio (1.40; 95% CI, 1.18-1.65) and area under curve (0.91; 95% CI, 0.86-0.96) for predicting ACS. An AV/CV ratio >= 1 (48% of the cohort) had a sensitivity of 97% and a specificity of 70% to identify ACS.
dc.description.abstractConclusion: CT volumetry of adrenal adenomas and contralateral adrenal glands has a high discriminatory capacity to identify ACS. The combination of this simple and low-cost radiological phenotyping can supplement biochemical testing to substantially improve the identification of ACS.
dc.description.funderFondecyt
dc.fechaingreso.objetodigital2024-11-14
dc.fuente.origenWOS
dc.identifier.doi10.1210/clinem/dgac005
dc.identifier.eissn1945-7197
dc.identifier.issn0021-972X
dc.identifier.urihttps://doi.org/10.1210/clinem/dgac005
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/85922
dc.identifier.wosidWOS:000783663300046
dc.information.autorucEscuela de Medicina; Baudrand Biggs, Rene Felipe; 0000-0002-8655-4957; 1024
dc.information.autorucEscuela de Medicina; Olmos Borzone, Roberto Ignacio; S/I; 163754
dc.information.autorucEscuela de Medicina; Mertens Folch, Nicolas Andrés; S/I; 195727
dc.information.autorucEscuela de Medicina; Uslar Nawrath, Thomas Hermann; S/I; 187161
dc.information.autorucEscuela de Enfermería; Fernández Walker, Paula Soledad; S/I; 13225
dc.information.autorucEscuela de Medicina; Guarda Vega, Francisco; 0000-0001-9104-9499; 149942
dc.information.autorucEscuela de Medicina; San Francisco Reyes, Ignacio Felipe; 0000-0001-8344-6988; 152729
dc.information.autorucEscuela de Medicina; Huete Garin, Isidro Alvaro; 0000-0002-8746-1111; 731
dc.issue.numero5
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.finalE1953
dc.pagina.inicioE1946
dc.publisherENDOCRINE SOC
dc.revistaJournal of Clinical Endocrinology and Metabolism
dc.rightsacceso restringido
dc.subjectHypercortisolism
dc.subjectAdrenal incidentaloma
dc.subjectAdrenal volumetry
dc.subjectAdrenocorticotropic hormone
dc.subjectCushing syndrome
dc.subjectAdrenal cortex neoplasm
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleDiscriminative Capacity of CT Volumetry to Identify Autonomous Cortisol Secretion in Incidental Adrenal Adenomas
dc.typeartículo
dc.volumen107
sipa.codpersvinculados1024
sipa.codpersvinculados163754
sipa.codpersvinculados195727
sipa.codpersvinculados187161
sipa.codpersvinculados13225
sipa.codpersvinculados149942
sipa.codpersvinculados152729
sipa.codpersvinculados731
sipa.trazabilidadWOS;2022-07-08
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