Correlation between Radiologic and Pathologic Dimensions of Adrenal Masses

Abstract

The size of adrenal tumors has been shown to be a good predictor of malignancy. There is still some controversy about the concordance between radiologic and real pathologic measurements. The aim of this study is to determine the correlation between direct and corrected radiologic computed tomography scan dimensions and the measurements of the resected specimen. A total of 41 adrenal tumors were included. Direct and corrected measurements of the largest diameter were contrasted with the pathologic dimensions. The Linos formula was used for the corrected measurements. Proper statistics were used considering a two-tailed significance level of 0.05. The intraclass correlations using direct and corrected measurements were 0.89 [95% confidence interval (95%CI) 0.81-0.94, p = 0.00001) and 0.90 (95%CI 0.82-0.95, p = 0.00001), respectively. The bivariate analysis using Pearson's correlation between two-dimensional group variables showed r = 0.82 (p < 0.0001) when direct and pathologic measurements were compared and r = 0.83 (p < 0.0001) when the corrected values were compared with the real dimensions. In this study, we demonstrate good correlation between radiologic and pathologic measurements of adrenal tumors. The Linos formula turned out to be significantly more accurate than direct radiologic measurements when means of the groups were compared, whereas when individual correlations were determined the two were similar. The Linos formula and radiologic measurements can be used to determine the proper management of adrenal incidentalomas in individual patients.

The optimal imaging of adrenal tumours: a comparison of different methods

“…For lesions O6 cm, the ratio of benign to malignant tumours is 1:8 (Bertherat et al 2002). Because size is important in the assessment and management of adrenal lesions, it is important to point out that CT is known to underestimate the size of adrenal tumours (Fajardo et al 2004). To improve the performance of CT against histological size, a formula has been proposed by Linos (2000).…”

The prognostic value of two different histopathological scoring systems for adrenocortical carcinomas

“…A tumour > 50 mm in diameter on computed tomography (CT) should be resected surgically to exclude malignancy 3 . Some would propose that tumours weighing > 50 g should be regarded as malignant 9 . Mitotane (op'DDD) is considered the adjuvant treatment of choice for patients with radically resected ACC.…”

“…8 Malignancy risk rises with increasing size and weight of the tumour. 1,9 A tumour > 50 mm in diameter on computed tomography (CT) should be resected surgically to exclude malignancy. 3 Some would propose that tumours weighing > 50 g should be regarded as malignant.…”

“…3 Some would propose that tumours weighing > 50 g should be regarded as malignant. 9 Mitotane (op'DDD) is considered the adjuvant treatment of choice for patients with radically resected ACC. Mitotane is also the therapy of choice in metastasized disease not amenable to surgery.…”

Giant Adrenal Pseudocyst Treated Laparoscopically; Case Report and Review of the Literature

“…Size varies widely and may correlate with the degree of malignancy. Asymptomatic, non-functional tumors smaller than 3 cm are less likely to be malignant than cysts larger than 6cm [7].…”