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- W4386154667 abstract "Preferred size threshold recommendations for management of incidental adrenal lesions remain controversial.This meta-analysis aimed to compare the diagnostic accuracy of different size thresholds for detecting malignancy in patients with incidental adrenal lesions on imaging.A systematic review of MEDLINE, EMBASE, Scopus, the Cochrane Library, and the Grey Literature from inception to September 2021 was performed. Studies with >10 patients evaluating the diagnostic accuracy of imaging size thresholds for detecting malignancy in patients with incidental adrenal lesions and no prior history of cancer were included. Study, clinical, imaging, and accuracy data for eligible studies was independently acquired by two reviewers. Primary meta-analysis was performed using bivariate mixed-effects regression model. Risk of bias was evaluated using QUADAS-2.From 2690 citations, 40 studies (9794 patients with mean age ranging from 41-66 years) were included. Most were retrospective single center studies (36/40). CT+/- MRI served as the index test(s). Sensitivity and specificity values by size threshold used in the included studies were: 85% (95% CI 74-91%) and 39% (23-57%) for 3 cm, 85% (78-90%) and 75% (62-85%) for 4 cm, 70% (56-81%) and 74% (59-85%) for 5 cm, and 75% (67-82%) and 77% (62-87%) for 6 cm thresholds. No cause for variability in sensitivity nor specificity was identified on subgroup analysis of the 4 cm threshold. Nearly half of the studies (19/40) had at least one QUADAS-2 domain with a high risk of bias.A 4 cm size threshold demonstrates the highest combined sensitivity and specificity with a preserved specificity compared to higher size thresholds but with a trend towards improved sensitivity. Future research re-evaluating 4-5 cm size thresholds while excluding characteristically benign lesions by imaging may help re-define a size threshold with improved specificity but preserved sensitivity compared to the existing 4 cm threshold." @default.
- W4386154667 created "2023-08-26" @default.
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- W4386154667 date "2023-08-01" @default.
- W4386154667 modified "2023-09-27" @default.
- W4386154667 title "Impact of size thresholds on the diagnosis of incidental adrenal lesions: A systematic review and meta-analysis" @default.
- W4386154667 doi "https://doi.org/10.1016/j.jacr.2023.04.027" @default.
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