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KMID : 1001020080060030122
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Journal of Urologic Oncology
2008 Volume.6 No. 3 p.122 ~ p.126
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Comparative Analysis of Real Size and Computed Tomography - Estimated Size of Adrenal Tumor
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Kim Han-Gwun
Park Chang-Hoo
Kim Sung-Jin
Park Chang-Myun
Kim Choung-Soo
Song Ki-Hyun
Ahn Han-Jong
Chung Hyun-Chul
Song Jae-Mann
Park Jong-Yeon
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Abstract
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Purpose: The adrenal mass size plays an important role in the indication for surgical excision. Computed tomography (CT) has been reported to underestimate the real size of adrenal lesion. But there is no accurate data in Korea. Then we investigate the accuracy of CT in the pre-operative determination of true adrenal tumor size.
Materials and Methods : The medical records of 84 patients who underwent adrenalectomy for adrenal mass were reviewed. Adrenal tumors were divided into three groups on the basis of CT-estimated size: less than 3 centimeters, 3 to 5.9 centimeters, greater than 5.9 centimeters. The size of adrenal tumors as determined by pre-operative CT was compared with the true histopathological size. We use paired t-test and chi-square test for statistical analysis.
Results: We found that CT consistently underestimated adrenal tumor size in all study groups. The mean underestimated difference was 19.2 percent (p=0.001) and 11.6 percent (p＜0.001) for each group 1 and group 2, but 4.5 percent for group 3 (p=0.058). The underestimation frequency is higher for tumors less than 5.9 centimeters than more than 5.9 centimeters. But, the regression line relating CT-estimated and histopathological tumor size was linear (R2=0.98, p＜0.001).
Conclusions : CT seemed to underestimate the real size of adrenal tumors, especially in small adrenal tumors. Because the decision to operate on nonfunctioning adrenal tumors is based on tumor size and because CT is currently the standard technique to estimate size, surgeons should cautiously consider the our finding before undertaking surgical treatment, especially when considering surgical or conservative management of small nonfunctioning adrenal tumors
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KEYWORD
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Adrenal mass, Adrenal tumor, Computed tomography, Size
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