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Effectiveness of a three-dimensional dual gradient echo two-point Dixon technique for the characterization of adrenal lesions at 3 Tesla

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Abstract

Objective

To compare the sensitivity, specificity, and diagnostic accuracy of fat-only datasets reconstructed using a two-point Dixon technique, with corresponding opposed-phase (OP) and in-phase (IP) datasets for characterization of adrenal lesions at 3 Tesla (T).

Methods

Fifty-nine patients (21 male, 38 female) with 66 adrenal lesions (49 adenomas, 17 nonadenomas) underwent 3D dual gradient-echo 3-T adrenal MR imaging with reconstruction of OP/IP and fat/water datasets. Sensitivity, specificity, and diagnostic accuracy were compared between OP/IP datasets, using the signal intensity index (SII), and fat/water datasets, using the fat fraction and fat ratio. Four radiologists qualitatively assessed OP/IP and fat-only datasets for reader confidence in lesion characterization and image quality.

Results

There were significant differences between adenomas and nonadenomas with regard to mean SII, fat fraction, and fat ratio (P < 0.001). There was no significant difference in mean diagnostic accuracy among different evaluation methods using OP/IP and fat/water datasets. Mean readers’ scores for lesion characterization were significantly higher for adenomas than for nonadenomas using OP/IP and fat-only datasets. There was no significant difference between the two datasets regarding mean readers’ scores for image quality.

Conclusion

Fat-only images can readily differentiate adrenal adenomas from nonadenomas, with diagnostic accuracy comparable to OP/IP images.

Key Points

• Incidental adrenal lesions are commonly encountered in radiology practice

• MR has been used to identify lesions giving cause for concern.

• 3T MR provides excellent demonstration of the effects of fat within structures

• Fat-only 3T MR images can readily differentiate adrenal adenomas from nonadenomas

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Acknowledgements

One of the authors of this study (BMD) is an employee of Siemens Medical Solutions. Another author (DM), who is not an employee of, or consultant for Siemens Medical Solutions had control of inclusion of any data and information that might present a conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Duke University Medical Center, Duke North—Room 1417, Erwin Road, Durham, NC, 27710, USA

    Daniele Marin, Mustafa R. Bashir, Timothy J. Ziemlewicz, Daniel T. Boll & Elmar M. Merkle

  2. Department of Radiology, Hannover Medical School, Carl-Neuberg Strasse 1, 30625, Hannover, Germany

    Kristina I. Ringe

  3. Siemens Medical Solutions, Cary, NC, 27560-7127, USA

    Brian M. Dale

Authors
  1. Daniele Marin
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  2. Brian M. Dale
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  3. Mustafa R. Bashir
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  4. Timothy J. Ziemlewicz
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  5. Kristina I. Ringe
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  6. Daniel T. Boll
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  7. Elmar M. Merkle
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Correspondence to Elmar M. Merkle.

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Marin, D., Dale, B.M., Bashir, M.R. et al. Effectiveness of a three-dimensional dual gradient echo two-point Dixon technique for the characterization of adrenal lesions at 3 Tesla. Eur Radiol 22, 259–268 (2012). https://doi.org/10.1007/s00330-011-2244-x

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  • DOI: https://doi.org/10.1007/s00330-011-2244-x

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