Preoperative Detection of Liver Involvement by Right-Sided Adrenocortical Carcinoma Using CT and MRI
The major prognosis factor of adrenocortical carcinoma (ACC) is the completeness of surgery. The aim of our study was to identify preoperative imaging features associated with direct liver involvement (DLI) by right-sided ACC. Two radiologists, blinded to the outcome, independently reviewed preopera...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/7/1603 |
| _version_ | 1797539382987587584 |
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| author | Alice Kedra Anthony Dohan Sébastien Gaujoux Mathilde Sibony Anne Jouinot Guillaume Assié Lionel Groussin Rouiller Rossella Libé Jérôme Bertherat Philippe Soyer Maxime Barat |
| author_facet | Alice Kedra Anthony Dohan Sébastien Gaujoux Mathilde Sibony Anne Jouinot Guillaume Assié Lionel Groussin Rouiller Rossella Libé Jérôme Bertherat Philippe Soyer Maxime Barat |
| author_sort | Alice Kedra |
| collection | DOAJ |
| description | The major prognosis factor of adrenocortical carcinoma (ACC) is the completeness of surgery. The aim of our study was to identify preoperative imaging features associated with direct liver involvement (DLI) by right-sided ACC. Two radiologists, blinded to the outcome, independently reviewed preoperative CT and MRI examinations for eight signs of DLI, in patients operated for right-sided ACC and retrospectively included from November 2007 to January 2020. DLI was confirmed using surgical and histopathological findings. Kappa values were calculated. Univariable and multivariable analyses were performed by using a logistic regression model. Receiver operating characteristic (ROC) curves were built for CT and MRI. Twenty-nine patients were included. Seven patients had DLI requiring <i>en bloc</i> resection. At multivariable analysis, focal ACC bulge was the single independent sign associated with DLI on CT (OR: 60.00; 95% CI: 4.60–782.40; <i>p</i> < 0.001), and ACC contour disruption was the single independent sign associated with DLI on MRI (OR: 126.00; 95% CI: 6.82–2328.21; <i>p</i> < 0.001). Both signs were highly reproducible, with respective kappa values of 0.85 and 0.91. The areas under ROC curves of MRI and CT models were not different (<i>p</i> = 0.838). Focal ACC bulge on CT and ACC contour disruption on MRI are independent and highly reproducible signs, strongly associated with DLI by right-sided ACC on preoperative imaging. MRI does not improve the preoperative assessment of DLI by comparison with CT. |
| first_indexed | 2024-03-10T12:45:16Z |
| format | Article |
| id | doaj.art-2a81900583c54f2dabfc584d311e5fff |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T12:45:16Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-2a81900583c54f2dabfc584d311e5fff2023-11-21T13:31:40ZengMDPI AGCancers2072-66942021-03-01137160310.3390/cancers13071603Preoperative Detection of Liver Involvement by Right-Sided Adrenocortical Carcinoma Using CT and MRIAlice Kedra0Anthony Dohan1Sébastien Gaujoux2Mathilde Sibony3Anne Jouinot4Guillaume Assié5Lionel Groussin Rouiller6Rossella Libé7Jérôme Bertherat8Philippe Soyer9Maxime Barat10Department of Diagnostic and Interventional Imaging, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, FranceDepartment of Diagnostic and Interventional Imaging, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, FranceFaculté de Médecine, Université de Paris, 75006 Paris, FranceFaculté de Médecine, Université de Paris, 75006 Paris, FranceFaculté de Médecine, Université de Paris, 75006 Paris, FranceFaculté de Médecine, Université de Paris, 75006 Paris, FranceFaculté de Médecine, Université de Paris, 75006 Paris, FranceDepartment of Endocrinology, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, FranceFaculté de Médecine, Université de Paris, 75006 Paris, FranceDepartment of Diagnostic and Interventional Imaging, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, FranceDepartment of Diagnostic and Interventional Imaging, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, FranceThe major prognosis factor of adrenocortical carcinoma (ACC) is the completeness of surgery. The aim of our study was to identify preoperative imaging features associated with direct liver involvement (DLI) by right-sided ACC. Two radiologists, blinded to the outcome, independently reviewed preoperative CT and MRI examinations for eight signs of DLI, in patients operated for right-sided ACC and retrospectively included from November 2007 to January 2020. DLI was confirmed using surgical and histopathological findings. Kappa values were calculated. Univariable and multivariable analyses were performed by using a logistic regression model. Receiver operating characteristic (ROC) curves were built for CT and MRI. Twenty-nine patients were included. Seven patients had DLI requiring <i>en bloc</i> resection. At multivariable analysis, focal ACC bulge was the single independent sign associated with DLI on CT (OR: 60.00; 95% CI: 4.60–782.40; <i>p</i> < 0.001), and ACC contour disruption was the single independent sign associated with DLI on MRI (OR: 126.00; 95% CI: 6.82–2328.21; <i>p</i> < 0.001). Both signs were highly reproducible, with respective kappa values of 0.85 and 0.91. The areas under ROC curves of MRI and CT models were not different (<i>p</i> = 0.838). Focal ACC bulge on CT and ACC contour disruption on MRI are independent and highly reproducible signs, strongly associated with DLI by right-sided ACC on preoperative imaging. MRI does not improve the preoperative assessment of DLI by comparison with CT.https://www.mdpi.com/2072-6694/13/7/1603adrenocortical carcinomaliverhepatectomyneoplasmstaging |
| spellingShingle | Alice Kedra Anthony Dohan Sébastien Gaujoux Mathilde Sibony Anne Jouinot Guillaume Assié Lionel Groussin Rouiller Rossella Libé Jérôme Bertherat Philippe Soyer Maxime Barat Preoperative Detection of Liver Involvement by Right-Sided Adrenocortical Carcinoma Using CT and MRI Cancers adrenocortical carcinoma liver hepatectomy neoplasm staging |
| title | Preoperative Detection of Liver Involvement by Right-Sided Adrenocortical Carcinoma Using CT and MRI |
| title_full | Preoperative Detection of Liver Involvement by Right-Sided Adrenocortical Carcinoma Using CT and MRI |
| title_fullStr | Preoperative Detection of Liver Involvement by Right-Sided Adrenocortical Carcinoma Using CT and MRI |
| title_full_unstemmed | Preoperative Detection of Liver Involvement by Right-Sided Adrenocortical Carcinoma Using CT and MRI |
| title_short | Preoperative Detection of Liver Involvement by Right-Sided Adrenocortical Carcinoma Using CT and MRI |
| title_sort | preoperative detection of liver involvement by right sided adrenocortical carcinoma using ct and mri |
| topic | adrenocortical carcinoma liver hepatectomy neoplasm staging |
| url | https://www.mdpi.com/2072-6694/13/7/1603 |
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