CT imaging of solid renal masses: pitfalls and solutions

Krishna, Satheesh; Murray, Catherine; McInnes, Matthew D. F.; Chatelain, Robert P.; Siddaiah, Mahadevaswamy; Dandan, Omran Al; Narayanasamy, Sabarish; Schieda, Nicola

doi:10.1016/j.crad.2017.05.003

Cited by 76 publications

(49 citation statements)

References 88 publications

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“…Imaging findings that should raise the suspicion of AML include the absence of calcification, the absence of perinephric collateral vessels, multiple lesions, hyperattenuation in comparison to renal parenchyma on UECT, and hypointensity on T2-weighted MRI. However, because these characteristic features are not present in every AML and exceptions do exist, no single finding or modality is perfectly accurate [2021222324]. …”

Section: Diagnosismentioning

confidence: 99%

Renal Angiomyolipoma: The Good, the Bad, and the Ugly

Vos

Oyen

2018

Journal of the Belgian Society of Radiology

106

126

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Angiomyolipomas (AMLs) are the most common benign renal tumours. Most of these neoplasms are found incidentally on imaging. However, symptomatic presentation does exist.Renal AMLs are typically composed of smooth muscle, blood vessels, and adipose tissue. Because of the abundant fat tissue, they give a characteristic appearance on imaging and are therefore easily diagnosed. However, sometimes they contain too little fat to be detected. This increases the difficulty in differentiating them from renal cell carcinoma (RCC).Management of AML is based on clinical presentation and should be individualized for every patient. Treatment modalities range from active surveillance to more invasive approaches.

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Section: Diagnosismentioning

confidence: 99%

Renal Angiomyolipoma: The Good, the Bad, and the Ugly

Vos

Oyen

2018

Journal of the Belgian Society of Radiology

106

126

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“…The recent technical advance of dual‐energy CT (DECT) has provided the material‐specific imaging, also known as material decomposition, which can separate several numbers of substances, such as water, iodine, calcium, uric acid, and fat . Especially, quantitative information for iodine distribution, among the DECT‐based material decomposition techniques, has been considered a promising tool for lesion characterization to distinguish not only malignancy from benignity but also hyperdense cystic lesions or hematomas from enhancing lesions . In the head and neck region, several studies showed iodine concentration (IC) could be useful in CT imaging of cervical lymph nodes or patients with underlying neck malignancy .…”

Section: Introductionmentioning

confidence: 99%

Dual‐energy CT iodine quantification for characterizing focal thyroid lesions

Lee

Seo

et al. 2018

Head & Neck

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Background To determine the usefulness of dual‐energy CT (DECT) iodine quantification to classify the focal thyroid lesions. Methods We retrospectively enrolled a total of 76 cytopathologically confirmed focal thyroid lesions (mean size: 1.9 cm). After drawing a region of interest on the DECT‐derived iodine maps, the obtained iodine concentration values of thyroid nodules (IC_N) and normalized IC_N were compared between 3 groups: papillary thyroid carcinoma (PTC), benign nodule, and cyst. Results From all lesions, 46, 17, and 13 were assigned to the PTC, benign nodule, and cyst groups. IC_N was the highest in the benign nodule, lower in the PTC, and the lowest in the cyst (median [interquartile range]: 4.3 [3.13‐5.48], 3.15 [2.29‐4.01], 0.60 [0.33‐0.88], all P < .001). Similarly, the normalized IC_N values were all statistically different from each other (P < .05).The multi‐class area under the curves using the optimal cutoff values were 0.931 for IC_N and 0.918, 0.920 for normalized IC, respectively. Conclusion DECT iodine quantification could be helpful to classify the focal thyroid lesions.

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“…In case of less attenuation (an attenuation of >20 HU may concern an RCC) causing doubt in the diagnosis, a contrast-enhanced series should be checked for tumor enhancement. A lack of enhancement confirms the lesion to be cystic [41]. After contrast administration, an enhancement of >20 HU measured in the CMP compared with the unenhanced phase marks a tumor as indeterminate and suspicious for RCC [41].…”

Section: Cysts and Enhancementmentioning

confidence: 88%

“…A lack of enhancement confirms the lesion to be cystic [41]. After contrast administration, an enhancement of >20 HU measured in the CMP compared with the unenhanced phase marks a tumor as indeterminate and suspicious for RCC [41]. Optimal sensitivity and specificity for RCC detection are reported when a cut off value of 84 HU in the CMP and 44 in the NP are used for the tumor [42].…”

Section: Cysts and Enhancementmentioning

confidence: 98%

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Diagnostic Imaging for Solid Renal Tumors: A Pictorial Review

Oostenbrugge

Fütterer

Mulders

2018

KCA

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Abstract. The prognosis of renal tumors depends on histologic subtype. The increased use of abdominal imaging has resulted in an increase in the number of small renal incidentaloma in recent decades. Of these incidentally discovered tumors, 20% are benign lesions warranting conservative management, but most are renal cell carcinomas that warrant a more aggressive therapeutic approach due to their malignant potential. Dedicated diagnostic renal imaging is important for characterization of renal tumors to facilitate treatment planning. This review discusses the ability to detect and differentiate renal cell carcinoma subtypes, angiomyolipoma and oncocytoma based on ultrasound imaging, computed tomography, multiparametric magnetic resonance, and nuclear imaging.

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CT imaging of solid renal masses: pitfalls and solutions

Cited by 76 publications

References 88 publications

Renal Angiomyolipoma: The Good, the Bad, and the Ugly

Renal Angiomyolipoma: The Good, the Bad, and the Ugly

Dual‐energy CT iodine quantification for characterizing focal thyroid lesions

Diagnostic Imaging for Solid Renal Tumors: A Pictorial Review

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