{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:17:02Z","timestamp":1792459022774,"version":"4.5.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T00:00:00Z","timestamp":1575244800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Acta Radiol"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Differentiation of adenoma and pheochromocytoma on computed tomography (CT) may be problematic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate if adenoma and pheochromocytoma can be differentiated with adrenal CT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>A total of 147 pathologically proven adrenal masses (119 adenomas, 28 pheochromocytomas) that had undergone adrenal CT were retrospectively evaluated. Lesion attenuation on unenhanced phase (UEP), portal phase (PP), 15-min delayed phase (DP), absolute\/relative percentage enhancement wash-out (APEW\/RPEW), and qualitative features were recorded. Student\u2019s t-test for parametric data, Mann\u2013Whitney U test for non-parametric data, and Fisher\u2019s exact test for categorical data were used. Diagnostic performance of CT attenuation was assessed by area under the curve (AUC) of the receiver operating characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>APEW of adenomas was not significantly different from pheochromocytomas; 68.4% and 59% ( P\u2009= \u20090.284). Adenomas had significantly higher RPEW; 57.3% vs. 37.4% ( P\u2009= \u20090.004). Of pheochromocytomas, 50% met APEW &gt;60% or RPEW &gt;40% criteria, and therefore were misclassified as adenoma on wash-out CT. Of those, 80% (4\/5) were &lt;\u20093 cm. UEP, PP, and DP attenuations of pheochromocytomas were significantly higher than adenomas; however, they were overlapping. AUC for UEP, PP, and DP was 0.906, 0.784, and 0.926, respectively. Larger pheochromocytomas were more likely to contain necrosis compared to smaller pheochromocytomas and adenomas; 41.6% vs. 12.5% vs. 3%. Homogeneous enhancement was seen in 25% of pheochromocytomas and 49% of adenomas ( P\u2009= \u20090.018). No significant difference was found in terms of lesion borders and presence of fat\/calcification ( P\u2009&gt; \u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A considerable percentage of pheochromocytomas, especially smaller ones, demonstrate adenoma-like wash-out on CT. Heterogeneous enhancement, higher attenuation, and necrosis are more suggestive of pheochromocytoma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0284185119889568","type":"journal-article","created":{"date-parts":[[2019,12,3]],"date-time":"2019-12-03T00:14:38Z","timestamp":1575332078000},"page":"1080-1086","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Diagnostic performance of adrenal CT in the differentiation of adenoma and pheochromocytoma"],"prefix":"10.1177","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0727-9230","authenticated-orcid":false,"given":"Emre","family":"Altinmakas","sequence":"first","affiliation":[{"name":"Department of Radiology, Ko\u00e7 School of Medicine, Ko\u00e7 University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy D","family":"Perrier","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth G","family":"Grubbs","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey E","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9204-7161","authenticated-orcid":false,"given":"Victor G","family":"Prieto","sequence":"additional","affiliation":[{"name":"Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaan S","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,12,2]]},"reference":[{"key":"bibr1-0284185119889568","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.171.1.9648789"},{"key":"bibr2-0284185119889568","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2010.06.013"},{"key":"bibr3-0284185119889568","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.13.11389"},{"key":"bibr4-0284185119889568","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2433051978"},{"key":"bibr5-0284185119889568","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.207.2.9577483"},{"key":"bibr6-0284185119889568","doi-asserted-by":"publisher","DOI":"10.1038\/nmeth.2089"},{"key":"bibr7-0284185119889568","first-page":"82","volume":"37","author":"Oshmyansky 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