CT screening for lung cancer: Frequency of enlarged adrenal glands identified in baseline and annual repeat rounds

• Published in: European radiology Vol. 26; no. 12; pp. 4475 - 4481
• Main Authors: Hu, Minxia, Yip, Rowena, Yankelevitz, David Y., Henschke, Claudia I.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2016; Springer Nature B.V
• Subjects: Adrenal Gland Diseases - diagnostic imaging; Adrenal Gland Diseases - epidemiology; Adrenal Glands - diagnostic imaging; Adrenal Glands - pathology; Aftercare; Age Factors; Aged; Chest; Diagnostic Radiology; Disease Progression; Early Detection of Cancer; Female; Humans; Imaging; Incidence; Incidental Findings; Internal Medicine; Interventional Radiology; Logistic Models; Lung cancer; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - epidemiology; Male; Mass Screening; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Organ Size; Radiology; Retrospective Studies; Risk Factors; Smoking - epidemiology; Tomography, X-Ray Computed; Ultrasound; Adrenal enlargement; Adrenal masses; Current smokers; CT screening; Lung cancer
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-016-4331-5

Objectives 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. Materials and 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). Conclusion 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. Key Points • 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.