Morphologic Change in Computed Tomography of Aldosterone-Producing Adenoma after Radiofrequency Ablation. Issue 1 (February 2014)

• Record Type: Journal Article
• Authors: Lee, Ryan K.L.; Liu, Shirley Y.W.; Tong, Cina S.L.; Lee, Paul S.F.; Ng, Enders K.W.; Ahuja, Anil T.
• Is Part Of: Canadian Association of Radiologists journal. Volume 65:Issue 1(2014)
• Page Start: 86
• Page End: 90
• Publication Date: 2014-02
• Subjects: Adrenal adenoma -- Computed tomography -- Radiofrequency ablation; Radiology, Medical -- Periodicals; Radiology, Medical -- Canada -- Periodicals; 616.0757
• DOI: 10.1016/j.carj.2012.12.006
• Languages: English
• ISSNs: 0846-5371

Abstract

Objective: To evaluate the morphologic changes of aldosterone-producing adenoma (APA) on computed tomography (CT) before and after radiofrequency ablation (RFA) and to assess the factors that are important in determining successful complete ablation of these tumours. Method: Between August 2004 and August 2011, 24 consecutive patients with APA undergoing CT-guided percutaneous RFA were identified from our prospective database. The pre-RFA and post-RFA CT appearances of these APAs that showed positive biochemical response were reviewed retrospectively for their 3-dimensional size, tumour volume, and CT attenuation in terms of Hounsfield units (HU). A comparison of these parameters before and after RFA was performed. Results: In this study, there were 23 APAs in these 24 patients that showed biochemical cure of primary aldosteronism after RFA. When comparing post-RFA to pre-RFA CTs, there was no significant change in tumour size (14.5 mm vs 14.6 mm: P = .83) and tumour volume (1.55 cm 3 vs 1.59 cm 3 ; P = .41) after RFA. In nonenhanced CT images, there was no significant reduction in HU from pre-RFA to post-RFA measurements (4.4 HU vs 7.9 HU; P = .52). In contrast-enhanced CTs, there was a significant drop in HU after RFA (from 48.3 HU to 14.7 HU; P = .03). None of the included cases showed a focal region of contrast enhancement to suggest residual tumour. Conclusion: A change in tumour size, tumour volume, and HU in nonenhanced CT were unreliable in defining radiologic treatment success. Only changes in HU in contrast-enhanced CT was useful in confirming a positive treatment response after RFA for APA.