Andrea Farias Melo MD, Presenter: Nothing to Disclose

Sara R. Teixeira MD, Abstract Co-Author: Nothing to Disclose

Gyl Eanes Silva MD, PhD, Abstract Co-Author: Nothing to Disclose

Valdair Francisco Muglia MD, PhD, Abstract Co-Author: Nothing to Disclose

Jorge Elias MD, PhD, Abstract Co-Author: Nothing to Disclose

To assess the prognostic relevance of apparent diffusion coefficient value (ADC) in patients with adrenocortical carcinoma (ACC) and to investigate if there is correlation between ADC and ki-67 staining index (ki67), a tumor proliferation marker

Institutional board review approved the study design. Signed informed consent was waived. From January 2011 to December 2013, twelve patients with histopathologically confirmed ACC who underwent magnetic resonance imaging (MRI) were retrospectively included. A histogram-derived of ADC parameters was obtained from whole-lesion assessment of diffusion-weighted MRI. The 10th (ADC10) and 25th (ADC25) percentiles, minimum (ADCmin) and maximum ADCs (ADCmax), mean, and median of the ADCs were correlated with cellularity and ki67. Associations along with staging and disease-free survival were also analyzed. Mann-Whitney U test and Spearman’s rho were used.

There were 13 lesions in 7 adults and 5 pediatric patients (10 females). Mean age with standard deviation (sd) at the time of diagnosis was 324.4 months (286). Seven patients (53.8%) were at stage II, 4 (30.8%) at stage III, and 2 (15.4%) at stage IV. Mean disease-free survival (sd) was 546.1 days (376). Mean ADCs (sd) were 1,100 mm2/s (223), ADCmin 422 mm2/s (338), ADCmax 2,284 mm2/s (613), ADC10 846 mm2/s (173), and ADC25 944 mm2/s (179). Correlation was found between ADC10 and cellularity (Spearman’s rho = -.610) and a trend was observed for ADCmin and ADC25 (p = .058 and .052, respectively). There was no correlation between ADCs and ki67. There was correlation between disease-free survival and ADCmin, ADCmax, ADC10, and cellularity (Spearman’s rho = .83, -.58, .57, and - .60, respectively). There was no correlation between staging and ADC values or ki67.

In patients with ACC, when whole-lesion histograms were used to derive ADC parameters, ADCmin, ADCmax, and ADC10 correlated with disease-free survival and with cellularity of the tumors, better than did other ADC parameters. However, ADCs failed to correlate with tumor proliferation markers.

In adrenocortical carcinomas, ADC parameters derived from whole-lesion histograms correlated with clinical prognosticators and tumor cellularity, unlike traditional average ADC values.

Melo, A, Teixeira, S, Silva, G, Muglia, V, Elias, J, Assessment of Adrenocortical Carcinoma with Whole-lesion Apparent Diffusion Coefficient Histogram-derived Parameters: Correlation with Prognostic and Tumor Proliferative Markers.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010656.html