Rationale and Objectives
To evaluate the prevalence, size, and characteristics of gynecomastia on thoracic
computed tomography (CT) in patients with spinal and bulbar muscular atrophy (SBMA)
or amyotrophic lateral sclerosis (ALS), compared to those of patients with myasthenia
gravis (as controls).
Materials and Methods
A total of 189 male patients (SBMA [n = 15]; ALS [n = 76]; control [n = 98]) who underwent thoracic computed tomography were included. The size of breast
glandular tissue diameters, and characteristic of CT-depicted gynecomastia were compared.
Results
On multivariate logistic regression analysis, mean breast glandular tissue diameter
(adjusted odds ratio [aOR] 1.13, 95% confidence interval [CI] 1.08-1.19), maximum
breast glandular tissue diameter (aOR 1.14, 95% CI 1.08-1.20), prevalence of CT-depicted
gynecomastia (aOR 21.71, 95% CI 5.39-87.38), dendritic or diffuse pattern of gynecomastia
(aOR 35.30, 95% CI 8.02-155.40), and bilateral gynecomastia (aOR 41.96, 95% CI 10.20-172.69)
were positively associated with SBMA, but not ALS. On receiver operating characteristic
(ROC) analysis, the area under the curve of the mean breast tissue diameter for predicting
SBMA was 0.92 with the optimal cutoff value of 16.5 mm. The ROC analysis showed that
a maximum breast tissue diameter of 18.6 mm can also effectively distinguish SBMA
from controls.
Conclusion
These findings suggest that the evaluation of breast glandular tissue on thoracic
CT could be a screening examination to distinguish SBMA patients and assist in its
differential diagnosis.
Key Words
Abbreviations:
CT (computed tomography), SBMA (spinal and bulbar muscular atrophy), ALS (amyotrophic lateral sclerosis), aOR (adjusted odds ratio), CI (confidence interval), ROC (receiver operating characteristic), AUC (area under the curve), MND (motor neuron disease), MG (myasthenia gravis), BMI (body mass index), CK (Creatine kinase), AST (aspartate aminotransferase), ALT (and alanine aminotransferase), MGFA (Myasthenia Gravis Foundation of America)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 01, 2022
Accepted:
February 2,
2022
Received in revised form:
January 27,
2022
Received:
December 20,
2021
Identification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
