title: Echoplanar MR imaging for characterization of adrenal masses in patients with malignant neoplasms: preliminary evaluation of calculated T2 relaxation values.
abstract: OBJECTIVE
  We undertook this study to assess the utility of echoplanar MR imaging for distinguishing benign from malignant adrenal masses in patients with known malignant neoplasms.
  
  
  METHODS
  Thirty consecutive patients with 31 adrenal masses and a known malignant neoplasm underwent breath-hold echoplanar MR imaging with a repetition time of 6000 msec and four echo times (40, 80, 120, 160 msec) on a 1.5-T unit before biopsy. Subsequently, 10 masses were shown to be malignant at histologic examination, 12 masses were benign at histologic examination, and nine were thought to be benign because they had not changed in size at follow-up imaging. Mean lesion size was 2.4 +/- 2.1 cm. T2 calculations using regions of interest in the liver and adrenal mass were performed in each patient.
  
  
  RESULTS
  The mean calculated T2 value of benign adrenal masses was 70.3 msec (SD, 11.6 msec) versus 104.6 msec (SD, 35.2 msec) for malignant adrenal masses (p = .013). Using a cutoff T2 value of 84 msec, 19 (90%) of 21 benign masses and nine (90%) of 10 malignant masses were correctly classified. The mean adrenal/liver T2 ratio was 1.4 (SD, 0.25) for benign lesions, and 2.1 (SD, 0.78) for malignant lesions (p = .017). Using a cutoff ratio of 1.60, 19 (90%) of 21 benign lesions and eight (80%) of 10 malignant lesions would have been correctly classified.
  
  
  CONCLUSIONS
  This preliminary work suggests that obtaining T2 calculations from echoplanar MR images of adrenal masses is a useful technique for distinguishing benign from malignant adrenal masses in patients at risk for adrenal metastasis.
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
authors.forename: L H
authors.initials: LH
authors.lastname: Schwartz
authors.forename: D M
authors.initials: DM
authors.lastname: Panicek
authors.forename: J A
authors.initials: JA
authors.lastname: Koutcher
authors.forename: R T
authors.initials: RT
authors.lastname: Heelan
authors.forename: M S
authors.initials: MS
authors.lastname: Bains
authors.forename: M
authors.initials: M
authors.lastname: Burt
mesh_terms: D000236:Adenoma / Q000175:diagnosis; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D000311:Adrenal Glands / Q000473:pathology; D000328:Adult; D000368:Aged; D017352:Echo-Planar Imaging; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies