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Differentiation of Clear Cell Renal Cell Carcinoma From Other Subtypes and Fat-Poor Angiomyolipoma by Use of Quantitative Enhancement Measurement During Three-Phase MDCT

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Author(s)
See Hyung Kim, Chan Sun Kim, Mi Jeong Kim, Jeong Yeon Cho, Seung Hyun Cho
Keimyung Author(s)
Kim, Mi JeongKim, See Hyung
Department
Dept. of Radiology (영상의학)
Journal Title
AJNR, American Journal of Neuroradiology
Issued Date
2016
Volume
206
Issue
1
Keyword
AngiomyolipomaEnhancementMDCTRenal cell carcinoma
Abstract
OBJECTIVE. The purpose of this study was to retrospectively assess whether measurement
of quantitative enhancement during three-phase MDCT can help differentiate clear cell renal
cell carcinoma (RCC) from papillary RCC, chromophobe RCC, and fat-poor angiomyolipoma.
MATERIALS AND METHODS. During preoperative three-phase MDCT (unenhanced,
corticomedullary, and early excretory phases), 563 lesions were identified in 552
consecutively registered patients. The lesions were assessed for attenuation in each phase, and
the attenuation values were compared by t test. Cutoff analysis of enhancement values (percentage
enhancement ratio, enhancement change, and absolute washout ratio) was performed
to determine optimal thresholds for the four types of lesions.
RESULTS. The mean attenuation of clear cell RCC was significantly greater than that of
papillary RCC and chromophobe RCC in the corticomedullary phase (clear cell, 139.7 HU;
papillary, 56.8 HU [p = 0.003]; chromophobe, 85.4 HU [p = 0.005]) and early excretory phase
(clear cell, 86.9 HU; papillary, 73.4 HU [p = 0.03]; chromophobe, 68.2 HU [p = 0.02]). It
was also significantly greater than that of fat-poor angiomyolipoma in the corticomedullary
phase (139.7 vs 99.6 HU, p = 0.02). Establishment of threshold enhancement values helped
to differentiate clear cell RCC from papillary RCC, chromophobe RCC, and fat-poor angiomyolipoma
with the following accuracies: percentage enhancement ratio, 84.7% (399/471)
for papillary RCC, 71.1% (325/457) for chromophobe RCC, and 81.9% (377/460) for fat-poor
angiomyolipoma; enhancement change, 80.9% (381/471) for papillary RCC, 70.2% (321/457)
for chromophobe RCC, and 80.6% (371/460) for fat-poor angiomyolipoma; absolute washout
ratio, 88.5% (417/471) for papillary RCC, 74.1% (339/457) for chromophobe RCC, and 85.0%
(391/460) for fat-poor angiomyolipoma.
CONCLUSION. Quantitative enhancement measurement may be useful for differentiating
clear cell RCC from papillary RCC, chromophobe RCC, and fat-poor angiomyolipoma.
Alternative Title
Differentiation of Clear Cell Renal Cell Carcinoma From Other Subtypes and Fat-Poor Angiomyolipoma by Use of Quantitative Enhancement Measurement During Three-Phase MDCT
Keimyung Author(s)(Kor)
김미정
김시형
Publisher
School of Medicine
Citation
See Hyung Kim, Chan Sun Kim, Mi Jeong Kim, Jeong Yeon Cho, Seung Hyun Cho. (2016). Differentiation of Clear Cell Renal Cell Carcinoma From Other Subtypes and Fat-Poor Angiomyolipoma by Use of Quantitative Enhancement Measurement During Three-Phase MDCT. AJNR, American Journal of Neuroradiology, 206(1), W21–W28–W21–W28. doi: 10.2214/AJR.15.14666
Type
Article
ISSN
0361-803X
Source
http://lps3.www.ajronline.org.proxy.dsmc.or.kr/doi/abs/10.2214/AJR.15.14666
DOI
10.2214/AJR.15.14666
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33182
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
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