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Journal of Diabetes & Metabolic Disorders
Published in: Journal of Diabetes & Metabolic Disorders 1/2015

Open Access 01-12-2015 | Review article

Likelihood ratio of computed tomography characteristics for diagnosis of malignancy in adrenal incidentaloma: systematic review and meta-analysis

Authors: Fatemeh Alsadat Sabet, Reza Majdzadeh, Babak Mostafazadeh Davani, Kazem Heidari, Akbar Soltani

Published in: Journal of Diabetes & Metabolic Disorders | Issue 1/2015

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Abstract

Purpose

To propose an evidence based diagnostic algorithm using mass characteristics to determine malignancy in patients with adrenal incidentaloma by CTscan.

Methods

A systematic review in Medline, Scopus, relevant reference books and desk searching was performed up to January 2016 with relevant reference checking. The summery estimates of sensitivity, specificity, positive and negative likelihood ratio of different characteristics were calculated in two groups of the articles investigating the cases without previous malignancy and the articles investigating the oncologic cases.

Results

Thirty six articles were included in this study. In the first group with no history of malignancy a positive and negative LR of 3.1 and 0.13 in 4 cm threshold and positive and negative LR of 2.85 and 0 in 10HU density were found. In the second group with history of malignancy positive and negative LR of 2.3 and 0.27 in 3 cm threshold and positive and negative LR of 3.6 and 0.08 in 20HU density were resulted.

Conclusion

The results retrieved in this study considering the limitations show that adrenal incidentaloma with a size less than 4 cm or a mass larger than 4 cm with density less than 10HU in the first group can be managed with imaging follow up. For masses larger than 4 cm with density more than 10HU another diagnostic procedure should be performed. In the second group an adrenal mass larger than 3 cm or less than 3 cm with density more than 20HU should go under operation. But masses smaller than 3 cm with less than 20HU density can be followed by imaging.
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Metadata
Title
Likelihood ratio of computed tomography characteristics for diagnosis of malignancy in adrenal incidentaloma: systematic review and meta-analysis
Authors
Fatemeh Alsadat Sabet
Reza Majdzadeh
Babak Mostafazadeh Davani
Kazem Heidari
Akbar Soltani
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Journal of Diabetes & Metabolic Disorders / Issue 1/2015
Electronic ISSN: 2251-6581
DOI
https://doi.org/10.1186/s40200-016-0224-z

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