{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:58:27Z","timestamp":1790891907935,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,8,29]],"date-time":"2016-08-29T00:00:00Z","timestamp":1472428800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>To determine the diagnostic performance of apparent diffusion coefficient (ADC) histogram analysis in diffusion\u2010weighted (DW) magnetic resonance imaging (MRI) for differentiating adrenal adenoma from pheochromocytoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We retrospectively evaluated 52 adrenal tumors (39 adenomas and 13 pheochromocytomas) in 47 patients (21 men, 26 women; mean age, 59.3 years; range, 16\u201386 years) who underwent DW 3.0T MRI. Histogram parameters of ADC (b\u2010values of 0 and 200 [ADC<jats:sub>200<\/jats:sub>], 0 and 400 [ADC<jats:sub>400<\/jats:sub>], and 0 and 800 s\/mm<jats:sup>2<\/jats:sup> [ADC<jats:sub>800<\/jats:sub>])\u2014mean, variance, coefficient of variation (CV), kurtosis, skewness, and entropy\u2014were compared between adrenal adenomas and pheochromocytomas, using the Mann\u2013Whitney <jats:italic>U<\/jats:italic>\u2010test. Receiver operating characteristic (ROC) curves for the histogram parameters were generated to differentiate adrenal adenomas from pheochromocytomas. Sensitivity and specificity were calculated by using a threshold criterion that would maximize the average of sensitivity and specificity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Variance and CV of ADC<jats:sub>800<\/jats:sub> were significantly higher in pheochromocytomas than in adrenal adenomas (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 and <jats:italic>P<\/jats:italic>\u2009=\u20090.001, respectively). With all b\u2010value combinations, the entropy of ADC was significantly higher in pheochromocytomas than in adrenal adenomas (all <jats:italic>P<\/jats:italic>\u2009\u2264\u20090.001), and showed the highest area under the ROC curve among the ADC histogram parameters for diagnosing adrenal adenomas (ADC<jats:sub>200<\/jats:sub>, 0.82; ADC<jats:sub>400<\/jats:sub>, 0.87; and ADC<jats:sub>800<\/jats:sub>, 0.92), with sensitivity of 84.6% and specificity of 84.6% (cutoff, \u22642.82) with ADC<jats:sub>200<\/jats:sub>; sensitivity of 89.7% and specificity of 84.6% (cutoff, \u22642.77) with ADC<jats:sub>400<\/jats:sub>; and sensitivity of 94.9% and specificity of 92.3% (cutoff, \u22642.67) with ADC<jats:sub>800<\/jats:sub>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ADC histogram analysis of DW MRI can help differentiate adrenal adenoma from pheochromocytoma.<\/jats:p><jats:p><jats:bold>Level of Evidence:<\/jats:bold> 3<\/jats:p><jats:p>J. Magn. Reson. Imaging 2017;45:1195\u20131203<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.25452","type":"journal-article","created":{"date-parts":[[2016,8,29]],"date-time":"2016-08-29T15:28:38Z","timestamp":1472484518000},"page":"1195-1203","source":"Crossref","is-referenced-by-count":55,"title":["ADC histogram analysis for adrenal tumor histogram analysis of apparent diffusion coefficient in differentiating adrenal adenoma from pheochromocytoma"],"prefix":"10.1002","volume":"45","author":[{"given":"Tomokazu","family":"Umanodan","sequence":"first","affiliation":[{"name":"Department of Radiology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Fukukura","sequence":"additional","affiliation":[{"name":"Department of Radiology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Kumagae","sequence":"additional","affiliation":[{"name":"Department of Radiology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshikazu","family":"Shindo","sequence":"additional","affiliation":[{"name":"Department of Radiology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoyo","family":"Nakajo","sequence":"additional","affiliation":[{"name":"Department of Radiology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Takumi","sequence":"additional","affiliation":[{"name":"Department of Radiology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Nakajo","sequence":"additional","affiliation":[{"name":"Department of Radiology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroto","family":"Hakamada","sequence":"additional","affiliation":[{"name":"Department of Radiology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Umanodan","sequence":"additional","affiliation":[{"name":"Department of Radiology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Yoshiura","sequence":"additional","affiliation":[{"name":"Department of Radiology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,8,29]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.2799"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2493070976"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.11.1427"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.24si045506"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-005-0017-0"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-007-0695-x"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.9620"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-014-0291-x"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.2463\/mrms.2013-0113"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2013.11.003"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/RCT.0b013e3182597613"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2011.09.016"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/RCT.0b013e31825975f8"},{"key":"e_1_2_5_15_1","first-page":"189","article-title":"Diffusion tensor imaging in the differentiation of adrenal adenomas and metastases","volume":"18","author":"Isik Y","year":"2012","journal-title":"Diagn Interv Radiol"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.4583"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.09.2891"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/RCT.0b013e31819f1b83"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.21616"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-011-2255-7"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2521081534"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.11110686"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2012.04.019"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12120167"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000002574"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.9545"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-014-3221-9"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2014.03.004"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.11110577"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0026256"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.25007"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-003-2121-3"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.9753"}],"container-title":["Journal of Magnetic Resonance Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjmri.25452","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjmri.25452","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmri.25452","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T04:48:23Z","timestamp":1694666903000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmri.25452"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8,29]]},"references-count":33,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,4]]}},"alternative-id":["10.1002\/jmri.25452"],"URL":"https:\/\/doi.org\/10.1002\/jmri.25452","archive":["Portico"],"relation":{},"ISSN":["1053-1807","1522-2586"],"issn-type":[{"value":"1053-1807","type":"print"},{"value":"1522-2586","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8,29]]}}}