Published in:
01-12-2016 | Chest
CT screening for lung cancer: Frequency of enlarged adrenal glands identified in baseline and annual repeat rounds
Published in: European Radiology | Issue 12/2016
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Objectives
To determine the frequency of adrenal enlargement of participants in a CT-screening program for lung cancer and demonstrate the progression during follow-up, separately for baseline and annual repeat rounds.
Materials and methods
HIPAA-compliant informed consent was obtained in 4,776 participants. The adrenal gland was defined as enlarged if it measured ≥6 mm at its largest diameter. Logistic regression analyses were performed.
Results
At baseline, 202 (4 %) of 4,776 participants had adrenal enlargement. Significant factors were age (OR = 1.4, 95 % CI: 1.2–1.7) and current smoker (OR = 1.8, 95 % CI: 1.3–2.4). Follow-up 7–18 months after baseline for 133 cases with adrenal enlargement <40 mm showed it decreased or was stable in 85 (64 %), and increased by <10 mm in 48 (36 %). Five (0.04 %) cases of adrenal enlargement were newly identified, none increased beyond 40 mm on follow-up. Adrenal enlargement was a significant predictor of a subsequent diagnosis of lung cancer (OR = 2.0, 95 % CI: 1.2–3.4).
Conclusion
Participants with adrenal enlargement <40 mm identified at baseline and on repeat screening could be reasonably assessed on subsequent annual screening. Adrenal enlargement increased with increasing pack-years of smoking. Adrenal enlargement was an independent predictor of a subsequent diagnosis of lung cancer.
Key Points
• Adrenal enlargement was seen in 4 % of participants at baseline screening.
• Age and currently smoking were significantly associated with adrenal enlargement.
• 0.04 % of participants were newly identified with adrenal enlargement.
• Annual follow-up for adrenal enlargement <40 mm was appropriate.
• Adrenal enlargement was an independent predictor of a diagnosis of lung cancer.