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Adrenal Washout Calculator

Calculate adrenal washout from CT imaging to diagnose adrenal adenomas

CT Scan Measurements

Non-contrast CT scan measurement

Contrast-enhanced scan at 60-75 seconds

Delayed scan at 15 minutes post-contrast

Results

Enter CT scan measurements to calculate adrenal washout

Calculation Formulas

Absolute Washout: 100 × [(Post HU - Delayed HU) / (Post HU - Pre HU)]

Relative Washout: 100 × [(Post HU - Delayed HU) / Post HU]

Enhancement: Post HU - Pre HU

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Reference Values

Adenoma Criteria

  • • Absolute washout 60%+
  • • Relative washout 40%+
  • • Pre-contrast HU under 10 (lipid-rich)

Exclusion Criteria

  • • Post-contrast HU 120+
  • • Pre-contrast HU 43+
  • • Inhomogeneous lesions
  • • Necrosis or hemorrhage

CT Protocol

  • • Non-contrast phase
  • • Post-contrast: 60-75 sec
  • • Delayed: 15 minutes

Clinical Notes

INFO:

Adenomas wash out contrast rapidly due to their vascular architecture

WARNING:

Pheochromocytomas may also show washout but rarely have lipid content

WARNING:

Hypervascular metastases may reduce washout specificity

NOTE:

Both absolute and relative washout provide complementary information

WARNING: Important Medical Disclaimer

This calculator is designed for healthcare professionals familiar with adrenal imaging interpretation. It provides mathematical calculations based on established washout criteria but should not replace clinical judgment or comprehensive radiological assessment.

For Healthcare Professionals Only: Results should be interpreted in the context of complete clinical history, physical examination, laboratory values, and comprehensive imaging findings. Consider additional imaging modalities (MRI, FDG-PET) when washout characteristics are indeterminate.

Not for Patient Self-Assessment: This tool requires specialized medical training to interpret. Patients should discuss results with their radiologist or endocrinologist for proper clinical correlation and management recommendations.

Understanding Adrenal Washout

What is Adrenal Washout?

Adrenal washout is a CT imaging technique used to differentiate benign adrenal adenomas from malignant lesions. It measures how quickly contrast material washes out of an adrenal lesion over time.

Clinical Significance

Benign adenomas typically show rapid contrast washout due to their rich blood supply and specific cellular characteristics, while malignant lesions tend to retain contrast longer.

Imaging Protocol

  • 1.Non-contrast phase: Baseline tissue attenuation
  • 2.Post-contrast (60-75s): Peak enhancement
  • 3.Delayed (15 min): Washout assessment

Interpretation Guidelines

Adenoma Characteristics

  • • Absolute washout 60%+
  • • Relative washout 40%+
  • • Homogeneous enhancement
  • • Well-defined margins

Concerning Features

  • • Pre-contrast HU 43+
  • • Post-contrast HU 120+
  • • Poor washout characteristics
  • • Irregular enhancement

Limitations

Washout analysis may be less reliable in patients with hypervascular primary tumors (renal cell carcinoma, hepatocellular carcinoma) due to hypervascular metastases that can mimic adenoma washout patterns.

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