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Korean J Urol Oncol > Volume 6(3); 2008 > Article
The Korean Journal of Urological Oncology 2008;6(3): 122-126.
부신 종양의 실제 크기와 전산단층촬영에서의 크기 비교분석
김한권, 박창후, 김성진, 박창면, 송기현1, 김청수1, 안한종1, 정현철2, 송재만2, 박종연
울산대학교 의과대학 강릉아산병원 비뇨기과, 1서울아산병원 비뇨기과, 2연세대학교 원주의과대학 비뇨기과학교실
Comparative Analysis of Real Size and Computed Tomography - Estimated Size of Adrenal Tumor
Han Kwon Kim , Chang Hoo Park , Sung Jin Kim , Chang Myeon Park , Ki Hyun Song 1, Choung Soo Kim 1, Han Jong Ahn 1, Hyun Chul Chung 2, Jae Mann Song 2, Jong Yeon Park
Departments of Urology, Gangneung Asan Hospital, 1Seoul Asan Hospital, College of Medicine, Ulsan University and 2Department of Urology, Yeonsei University Wonju College of Medicine, Wonju, Korea
Published online: December 1, 2008.
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.
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).
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. (Korean J Urol Oncol 2008;6:122-126)
Key Words: Adrenal mass; Adrenal tumor; Computed tomography; Size
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