Segmental enhancement inversion at biphasic multidetector CT: characteristic finding of small renal oncocytoma

To retrospectively determine the usefulness of segmental enhancement inversion during the corticomedullary phase (CMP) and early excretory phase (EEP) of biphasic multidetector computed tomography (CT) in differentiating small renal oncocytoma from renal cell carcinoma (RCC). This retrospective stud...

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Veröffentlicht in:Radiology 2009-08, Vol.252 (2), p.441-448
Hauptverfasser: Kim, Jung Im, Cho, Jeong Yeon, Moon, Kyung Chul, Lee, Hak Jong, Kim, Seung Hyup
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container_issue 2
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container_title Radiology
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creator Kim, Jung Im
Cho, Jeong Yeon
Moon, Kyung Chul
Lee, Hak Jong
Kim, Seung Hyup
description To retrospectively determine the usefulness of segmental enhancement inversion during the corticomedullary phase (CMP) and early excretory phase (EEP) of biphasic multidetector computed tomography (CT) in differentiating small renal oncocytoma from renal cell carcinoma (RCC). This retrospective study was institutional review board approved; informed consent was waived. Between January 2004 and December 2006, 98 patients with pathologically confirmed renal masses smaller than 4 cm (10 renal oncocytomas and 88 RCCs) were included in this study. Segmental enhancement inversion was defined as follows: In a mass with two segments showing different degrees of enhancement during CMP, the relatively highly enhanced segment became less enhanced during EEP, whereas the less-enhanced segment during CMP became highly enhanced during EEP. Two experienced radiologists retrospectively assessed the presence of segmental inversion in all masses and measured attenuation with consensus. The Fisher exact test was used to determine the significance of segmental enhancement inversion in differentiating small renal oncocytoma from RCC. Eight of 10 renal oncocytomas and only one of 88 RCCs showed segmental inversion during CMP and EEP, which significantly differentiated small renal oncocytomas and RCCs (P < .0001). For differentiating oncocytoma from RCC, segmental inversion was found to have a sensitivity of 80% (eight of 10), a specificity of 99% (87 of 88), a positive predictive value of 89% (eight of nine), and a negative predictive value of 98% (87 of 89). The mean values of the attenuation differences shown by two segments during CMP and EEP were 62.75 HU +/- 36.96 (standard deviation) and -36.88 HU +/- 20.02, respectively. Segmental enhancement inversion during CMP and EEP was found to be a characteristic enhancement pattern of small renal oncocytoma at biphasic multidetector CT and it may help in differentiating small oncocytoma from RCC. http://radiology.rsnajnls.org/cgi/content/full/2522081180/DC1.
doi_str_mv 10.1148/radiol.2522081180
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Eight of 10 renal oncocytomas and only one of 88 RCCs showed segmental inversion during CMP and EEP, which significantly differentiated small renal oncocytomas and RCCs (P &lt; .0001). For differentiating oncocytoma from RCC, segmental inversion was found to have a sensitivity of 80% (eight of 10), a specificity of 99% (87 of 88), a positive predictive value of 89% (eight of nine), and a negative predictive value of 98% (87 of 89). The mean values of the attenuation differences shown by two segments during CMP and EEP were 62.75 HU +/- 36.96 (standard deviation) and -36.88 HU +/- 20.02, respectively. 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Eight of 10 renal oncocytomas and only one of 88 RCCs showed segmental inversion during CMP and EEP, which significantly differentiated small renal oncocytomas and RCCs (P &lt; .0001). For differentiating oncocytoma from RCC, segmental inversion was found to have a sensitivity of 80% (eight of 10), a specificity of 99% (87 of 88), a positive predictive value of 89% (eight of nine), and a negative predictive value of 98% (87 of 89). The mean values of the attenuation differences shown by two segments during CMP and EEP were 62.75 HU +/- 36.96 (standard deviation) and -36.88 HU +/- 20.02, respectively. Segmental enhancement inversion during CMP and EEP was found to be a characteristic enhancement pattern of small renal oncocytoma at biphasic multidetector CT and it may help in differentiating small oncocytoma from RCC. http://radiology.rsnajnls.org/cgi/content/full/2522081180/DC1.</abstract><cop>United States</cop><pmid>19508984</pmid><doi>10.1148/radiol.2522081180</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects Adenoma, Oxyphilic - diagnostic imaging
Adult
Aged
Aged, 80 and over
Carcinoma, Renal Cell - diagnostic imaging
Diagnosis, Differential
Female
Humans
Kidney Neoplasms - diagnostic imaging
Male
Middle Aged
Radiographic Image Enhancement - methods
Radiographic Image Interpretation, Computer-Assisted - methods
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed - methods
Young Adult
title Segmental enhancement inversion at biphasic multidetector CT: characteristic finding of small renal oncocytoma
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