フククラ　ヨシヒコ   Yoshihiko Fukukura   福倉　良彦    所属   川崎医科大学  医学部 臨床医学　機能・代謝画像診断学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	ADC histogram analysis for adrenal tumor histogram analysis of apparent diffusion coefficient in differentiating adrenal adenoma from pheochromocytoma.
掲載誌名	正式名：Journal of magnetic resonance imaging : JMRI 略　 称：J Magn Reson Imaging ISSNコード：15222586/10531807
掲載区分	国外
巻・号・頁	45(4),pp.1195-1203
著者・共著者	Tomokazu Umanodan, Yoshihiko Fukukura, Yuichi Kumagae, Toshikazu Shindo, Masatoyo Nakajo, Koji Takumi, Masanori Nakajo, Hiroto Hakamada, Aya Umanodan, Takashi Yoshiura
発行年月	2017/04
概要	PURPOSE:To determine the diagnostic performance of apparent diffusion coefficient (ADC) histogram analysis in diffusion-weighted (DW) magnetic resonance imaging (MRI) for differentiating adrenal adenoma from pheochromocytoma.MATERIALS AND METHODS:We retrospectively evaluated 52 adrenal tumors (39 adenomas and 13 pheochromocytomas) in 47 patients (21 men, 26 women; mean age, 59.3 years; range, 16-86 years) who underwent DW 3.0T MRI. Histogram parameters of ADC (b-values of 0 and 200 [ADC200 ], 0 and 400 [ADC400 ], and 0 and 800 s/mm2 [ADC800 ])-mean, variance, coefficient of variation (CV), kurtosis, skewness, and entropy-were compared between adrenal adenomas and pheochromocytomas, using the Mann-Whitney U-test. 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.RESULTS:Variance and CV of ADC800 were significantly higher in pheochromocytomas than in adrenal adenomas (P < 0.001 and P = 0.001, respectively). With all b-value combinations, the entropy of ADC was significantly higher in pheochromocytomas than in adrenal adenomas (all P ≤ 0.001), and showed the highest area under the ROC curve among the ADC histogram parameters for diagnosing adrenal adenomas (ADC200 , 0.82; ADC400 , 0.87; and ADC800 , 0.92), with sensitivity of 84.6% and specificity of 84.6% (cutoff, ≤2.82) with ADC200 ; sensitivity of 89.7% and specificity of 84.6% (cutoff, ≤2.77) with ADC400 ; and sensitivity of 94.9% and specificity of 92.3% (cutoff, ≤2.67) with ADC800 .CONCLUSION:ADC histogram analysis of DW MRI can help differentiate adrenal adenoma from pheochromocytoma.LEVEL OF EVIDENCE:3 J. Magn. Reson. Imaging 2017;45:1195-1203.
DOI	10.1002/jmri.25452
PMID	27571307