CT screening for lung cancer: Frequency of enlarged adrenal glands identified in baseline and annual repeat rounds.
OBJECTIVE
To determine the frequency of adrenal enlargement of participants in a CT-screening program for lung cancer and demonstrate the progression during follow-up, separately for baseline and annual repeat rounds.


METHODS
HIPAA-compliant informed consent was obtained in 4,776 participants. The adrenal gland was defined as enlarged if it measured ≥6 mm at its largest diameter. Logistic regression analyses were performed.


RESULTS
At baseline, 202 (4 %) of 4,776 participants had adrenal enlargement. Significant factors were age (OR = 1.4, 95 % CI: 1.2-1.7) and current smoker (OR = 1.8, 95 % CI: 1.3-2.4). Follow-up 7-18 months after baseline for 133 cases with adrenal enlargement <40 mm showed it decreased or was stable in 85 (64 %), and increased by <10 mm in 48 (36 %). Five (0.04 %) cases of adrenal enlargement were newly identified, none increased beyond 40 mm on follow-up. Adrenal enlargement was a significant predictor of a subsequent diagnosis of lung cancer (OR = 2.0, 95 % CI: 1.2-3.4).


CONCLUSIONS
Participants with adrenal enlargement <40 mm identified at baseline and on repeat screening could be reasonably assessed on subsequent annual screening. Adrenal enlargement increased with increasing pack-years of smoking. Adrenal enlargement was an independent predictor of a subsequent diagnosis of lung cancer.


CONCLUSIONS
• Adrenal enlargement was seen in 4 % of participants at baseline screening. • Age and currently smoking were significantly associated with adrenal enlargement. • 0.04 % of participants were newly identified with adrenal enlargement. • Annual follow-up for adrenal enlargement <40 mm was appropriate. • Adrenal enlargement was an independent predictor of a diagnosis of lung cancer.
Department of Radiology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA.|Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China.
Minxia
M
Hu
Department of Radiology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA.
Rowena
R
Yip
Department of Radiology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA.
David Y
DY
Yankelevitz
Department of Radiology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA. claudia.henschke@mountsinai.org.
Claudia I
CI
Henschke
D000307:Adrenal Gland Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000311:Adrenal Glands / Q000000981:diagnostic imaging* / Q000473:pathology; D000359:Aftercare; D000367:Age Factors; D000368:Aged; D018450:Disease Progression; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D015994:Incidence; D033162:Incidental Findings; D016015:Logistic Models; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014057:Tomography, X-Ray Computed
Adrenal enlargement; Adrenal masses; CT screening; Current smokers; Lung cancer