{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:42:20Z","timestamp":1773967340057,"version":"3.50.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Curtin University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Abdom Radiol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To validate the diagnostic performance of adrenal washout CT in patients <jats:italic>without known malignancy<\/jats:italic> in a Western Australian population.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A radiology information system (RIS) search for CT reports containing \u201cadrenal\u201d and \u201cwashout\u201d across six networked\u00a0metropolitan public hospitals between January 2005 and November 2021. Homogenous nodules\u2009\u2265\u20091\u00a0cm,\u2009\u2265\u200910 HU without a suspected functional component in patients without a history of malignancy were included. Reported absolute and relative washout percentages were recorded and re-measured from unenhanced, 60-s portal venous and 15-min delayed phase imaging and compared to either histopathological or CT follow up for growth (\u2265\u200912\u00a0months) reference standards.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>2653 studies were screened with 191 meeting inclusion criteria. 105 nodules underwent washout CT and then had either histopathological (12 patients) or CT follow up (93 patients) reference standards available.<\/jats:p>\n                <jats:p>Reported absolute washout (aWO) estimated sensitivity and specificity for malignant\/indeterminate nodules was low at 33% (95% CI 25\u201343%) and 77% (95% CI 68\u201384%) respectively. Reported relative washout (rWO) sensitivity and specificity were 56% (95% CI 46\u201365%) and 69% (95% CI 60\u201377%) respectively. Negative predictive values for both aWO and rWO were reassuring at 92% (95% CI 86\u201396%) and 94% (95%CI 88\u201397%).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our study validates a recent report suggesting that adrenal washout has poor sensitivity for and consequent limited utility to exclude malignancy in patients with no cancer history. However, patients with incidental adrenal nodules\u2009&lt;\u20094\u00a0cm in size with benign washout can be reassured by the high negative predictive value and worked up to exclude functional adenoma and re-imaged in a year to confirm no growth.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00261-024-04333-5","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T19:01:41Z","timestamp":1716318101000},"page":"3117-3126","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Adrenal washout CT in patients with no history of cancer: a waste of time?"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5228-2087","authenticated-orcid":false,"given":"Timo","family":"van Aswegen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Trinh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0461-681X","authenticated-orcid":false,"given":"Angela","family":"Jacques","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6906-588X","authenticated-orcid":false,"given":"Glen","family":"Lo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,21]]},"reference":[{"issue":"1","key":"4333_CR1","doi-asserted-by":"publisher","first-page":"201","DOI":"10.2214\/ajr.171.1.9648789","volume":"171","author":"GW Boland","year":"1998","unstructured":"Boland, G. 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