title: Morphologic change in computed tomography of aldosterone-producing adenoma after radiofrequency ablation.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong/Chinese University of Hong Kong, Hong Kong. Electronic address: leekalok2909@yahoo.com.hk.
authors.forename: Ryan K L
authors.initials: RK
authors.lastname: Lee
authors.affiliation: Department of Surgery, Prince of Wales Hospital, Hong Kong.
authors.forename: Shirley Y W
authors.initials: SY
authors.lastname: Liu
authors.affiliation: Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong/Chinese University of Hong Kong, Hong Kong.
authors.forename: Cina S L
authors.initials: CS
authors.lastname: Tong
authors.affiliation: Department of Radiology, North District Hospital, Hong Kong.
authors.forename: Paul S F
authors.initials: PS
authors.lastname: Lee
authors.affiliation: Department of Surgery, Prince of Wales Hospital, Hong Kong.
authors.forename: Enders K W
authors.initials: EK
authors.lastname: Ng
authors.affiliation: Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong/Chinese University of Hong Kong, Hong Kong.
authors.forename: Anil T
authors.initials: AT
authors.lastname: Ahuja
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000601:surgery*; D000306:Adrenal Cortex Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000096:biosynthesis*; D017115:Catheter Ablation / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D000450:Aldosterone
keywords: Adrenal adenoma; Computed tomography; Radiofrequency ablation