Usefulness of rapid kV-switching dual energy CT in renal tumor characterization

Çamlıdağ İ., Nural M. S., Danacı M., Özden E.

ABDOMINAL RADIOLOGY, cilt.44, sa.5, ss.1841-1849, 2019 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 44 Sayı: 5
  • Basım Tarihi: 2019
  • Doi Numarası: 10.1007/s00261-019-01897-5
  • Dergi Adı: ABDOMINAL RADIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1841-1849
  • Anahtar Kelimeler: Rapid kV-switching dual energy CT, Renal tumor, Iodine content, CELL CARCINOMA, CLEAR-CELL, IODINE QUANTIFICATION, MULTIDETECTOR CT, ENHANCEMENT, SUBTYPES, MASSES, PSEUDOENHANCEMENT, DISCRIMINATION, ANGIOMYOLIPOMA
  • Ondokuz Mayıs Üniversitesi Adresli: Evet

Özet

PurposeTo investigate whether iodine content can discriminate between benign or malignant renal tumors, malign tumor subtypes, low-grade and high-grade tumors on rapid kv-switching dual-energy CT (rsDECT).MethodsThis prospective study enrolled 95 patients with renal tumors who underwent rsDECT for tumor characterization between 2016 and 2018. Attenuation on true and virtual unenhanced images, absolute enhancement and enhancement ratio and iodine content of each lesion on nephrographic phase iodine density images were measured. Histopathological diagnosis was obtained following either surgery or core biopsy.ResultsEighty-five tumors were renal cell carcinoma (RCC) (56 clear cell, 20 papillary, 9 chromophobe) and 10 were benign (6 angiomyolipoma,4 oncocytoma). 46 tumors were low-grade and 23 high-grade. There was significant difference between iodine content of clear cell and non-clear cell (papillary+chromophobe) RCC (p<0.001). However, no significant iodine content differences were found between papillary and chromophobe RCC, benign and malignant tumors, low-grade and high-grade tumors. The best cut-off iodine content for differentiating clear cell from non-clear cell RCC was 3.2mg/ml and clear cell from papillary RCC was 2.9mg/ml with a high sensitivity and specificity. Also, significant difference was found between attenuation values of true and virtual unenhanced images (p=0.007). Mean iodine content, absolute enhancement and enhancement ratio were highly correlated.ConclusionrsDECT contributes to renal tumor characterization by showing higher iodine content in clear cell RCCs compared with non-clear cell RCCs.