{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:25:26Z","timestamp":1788881126102,"version":"build-2803163510"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T00:00:00Z","timestamp":1670457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The purpose of this study was to establish a risk prediction model for differential diagnosis of pheochromocytomas (PCCs) from lipid-poor adenomas (LPAs) using a grouping method based on tri-phasic CT image features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective study, we enrolled patients that were assigned to a training set (136 PCCs and 183 LPAs) from two medical centers, along with an external independent validation set (30 PCCs and 54 LPAs) from another center. According to the attenuation values in unenhanced CT (CTu), the lesions were divided into three groups: group 1, 10 HU &amp;lt; CTu \u2264 25 HU; group 2, 25 HU &amp;lt; CTu \u2264 40 HU; and group 3, CTu &amp;gt; 40 HU. Quantitative and qualitative CT imaging features were calculated and evaluated. Univariate, ROC, and binary logistic regression analyses were applied to compare these features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cystic degeneration, CTu, and the peak value of enhancement in the arterial and venous phase (DEpeak) were independent risk factors for differential diagnosis of adrenal PCCs from LPAs. In all subjects (groups 1, 2, and 3), the model formula for the differentiation of PCCs was as follows: Y = -7.709 + 3.617*(cystic degeneration) + 0.175*(CTu \u2265 35.55 HU) + 0.068*(DEpeak \u2265 51.35 HU). ROC curves were drawn with an AUC of 0.95 (95% CI: 0.927\u20130.973) in the training set and 0.91 (95% CI: 0.860\u20130.929) in the external validation set.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A reliable and practical prediction model for differential diagnosis of adrenal PCCs and LPAs was established using a grouping method.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2022.925577","type":"journal-article","created":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T01:03:22Z","timestamp":1670461402000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Risk prediction model establishment with tri-phasic CT image features for differential diagnosis of adrenal pheochromocytomas and lipid-poor adenomas: Grouping method"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhongfeng","family":"Niu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongyu","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meihua","family":"Shao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangmei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp065470","article-title":"Clinical practice. the incidentally discovered adrenal mass","volume":"356","author":"Young","year":"2007","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1007\/s00261-019-02149-2","article-title":"Management of incidental adrenal masses: an update","volume":"45","author":"Glazer","year":"2020","journal-title":"Abdom Radiol (NY)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"G1","DOI":"10.1530\/EJE-16-0467","article-title":"Management of adrenal incidentalomas: European society of endocrinology clinical practice guideline in collaboration with the European network for the study of adrenal tumors","volume":"175","author":"Fassnacht","year":"2016","journal-title":"Eur J Endocrinol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7176.2009.0024.x","article-title":"Estimation of 24-hour sodium excretion from spot urine samples","volume":"12","author":"Mann","year":"2010","journal-title":"J Clin Hypertens (Greenwich)"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6823-4-2","article-title":"A systematic review of the literature examining the diagnostic efficacy of measurement of fractionated plasma free metanephrines in the biochemical diagnosis of pheochromocytoma","volume":"4","author":"Sawka","year":"2004","journal-title":"BMC Endocr Disord"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12112735","article-title":"Adenoma characterization: adrenal protocol with dual-energy CT","volume":"267","author":"Kim","year":"2013","journal-title":"Radiology"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-013-3084-7","article-title":"The value of 15-minute delayed contrast-enhanced CT to differentiate hyperattenuating adrenal masses compared with chemical shift MR imaging","volume":"24","author":"Koo","year":"2014","journal-title":"Eur Radiol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2493070976","article-title":"Incidental adrenal lesions: principles, techniques, and algorithms for imaging characterization","volume":"249","author":"Boland","year":"2008","journal-title":"Radiology"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-003-0015-0","article-title":"Differentiation of adrenal adenomas (lipid rich and lipid poor) from nonadenomas by use of washout characteristics on delayed enhanced CT","volume":"28","author":"Kebapci","year":"2003","journal-title":"Abdom Imaging"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-017-5076-5","article-title":"Pheochromocytoma as a frequent false-positive in adrenal washout CT: A systematic review and meta-analysis","volume":"28","author":"Woo","year":"2018","journal-title":"Eur Radiol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.9620","article-title":"Can established CT attenuation and washout criteria for adrenal adenoma accurately exclude pheochromocytoma","volume":"201","author":"Patel","year":"2013","journal-title":"AJR Am J Roentgenol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1097\/RCT.0000000000000343","article-title":"Adrenal adenoma and pheochromocytoma: Comparison of multidetector CT venous enhancement levels and washout characteristics","volume":"40","author":"Northcutt","year":"2016","journal-title":"J Comput Assist Tomogr"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.9753","article-title":"MDCT of adrenal masses: Can dual-phase enhancement patterns be used to differentiate adenoma and pheochromocytoma","volume":"20","author":"Northcutt","year":"2013","journal-title":"AJR Am J Roentgenol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-021-03121-9","article-title":"Differentiation of lipid-poor adenoma from pheochromocytoma on biphasic contrast-enhanced CT","volume":"46","author":"An","year":"2021","journal-title":"Abdom Radiol (NY)"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1177\/0284185119889568","article-title":"Diagnostic performance of adrenal CT in the differentiation of adenoma and pheochromocytoma","volume":"61","author":"Altinmakas","year":"2019","journal-title":"Acta Radiol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2342031876","article-title":"Adrenocortical carcinomas and adrenal pheochromocytomas: mass and enhancement loss evaluation at delayed contrast-enhanced CT","volume":"234","author":"Szolar","year":"2005","journal-title":"Radiology"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-020-02764-4","article-title":"Distinguishing pheochromocytoma from adrenal adenoma by using modified computed tomography criteria","volume":"46","author":"Kang","year":"2021","journal-title":"Abdom Radiol (NY)"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1148\/rg.295095027","article-title":"Adrenal mass imaging with multidetector CT: Pathologic conditions, pearls, and pitfalls","volume":"29","author":"Johnson","year":"2009","journal-title":"Radiographics"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021210231","article-title":"Relative enhancement ratio of portal venous phase to unenhanced CT in the diagnosis of lipid-poor adrenal adenomas","volume":"31","author":"Nagayama","year":"2021","journal-title":"Radiology"},{"key":"B20","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1530\/EC-19-0198","article-title":"Radiological differentiation of phaeochromocytoma from other malignant adrenal masses: importance of wash-in characteristics on multiphase CECT","volume":"8","author":"Goroshi","year":"2019","journal-title":"Endocr Connect"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2018-01532","article-title":"CT characteristics of pheochromocytoma: Relevance for the evaluation of adrenal incidentaloma","volume":"104","author":"Canu","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2020.03.04","article-title":"Not all adrenal incidentalomas require biochemical testing to exclude pheochromocytoma: Mayo clinic experience and a meta-analysis","volume":"9","author":"Gruber","year":"2020","journal-title":"Gland Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"2671","DOI":"10.1038\/s41598-022-06655-0","article-title":"Predictive model of pheochromocytoma based on the imaging features of the adrenal tumors","volume":"12","author":"Araujo-Castro","year":"2022","journal-title":"Sci Rep"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.925577\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T01:03:25Z","timestamp":1670461405000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.925577\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,8]]},"references-count":23,"alternative-id":["10.3389\/fendo.2022.925577"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2022.925577","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,8]]},"article-number":"925577"}}