ArticleEuropean radiology2020
Characterization of clear cell renal cell carcinoma and other renal tumors: evaluation of dual-energy CT using material-specific iodine and fat imaging.
Article in European radiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- The value of dual-energy CT radiomics in evaluating vascular maturity and prognosis in clear cell renal cell carcinoma.Discover oncology · 2025Article
- Role of DECT-Based Imaging Biomarkers and Machine Learning to Predict Renal Cell Carcinoma Subtypes.The Indian journal of radiology & imaging · 2025Article
- Research Progress of Dual-energy CT in Diagnosis and Evaluation of Curative Effect of Liver Cancer: A ReviewCurrent medical imaging · 2025Review
- Dual-Energy Computed Tomography in Urological Diseases: A Narrative Review.Journal of clinical medicine · 2024Review
- Spectral CT imaging versus conventional CT post-processing technique in differentiating malignant and benign renal tumors.The British journal of radiology · 2023Article
- Minimal Fat Content in Papillary Renal Cell Carcinoma Diagnosed with Dual-Layer Dual-Energy CT.Diagnostics (Basel, Switzerland) · 2023Article
- Differentiation of adrenal adenomas from adrenal metastases in single-phased staging dual-energy CT and radiomics.Diagnostic and interventional radiology (Ankara, Turkey) · 2022Article
- Dual-energy CT-based radiomics nomogram in predicting histological differentiation of head and neck squamous carcinoma: a multicenter study.Neuroradiology · 2022Article
- Article
- CT-based multi-phase Radiomic models for differentiating clear cell renal cell carcinoma.Cancer imaging : the official publication of the International Cancer Imaging Society · 2021Article
- Use of dual-energy CT for renal mass assessment.European radiology · 2021Review
- Dual-energy CT quantitative parameters for the differentiation of benign from malignant lesions and the prediction of histopathological and molecular subtypes in breast cancer.Quantitative imaging in medicine and surgery · 2021Article
- Effect of phase of enhancement on texture analysis in renal masses evaluated with non-contrast-enhanced, corticomedullary, and nephrographic phase-enhanced CT images.European radiology · 2021Article
- Dual-energy CT quantitative parameters for evaluating Immunohistochemical biomarkers of invasive breast cancer.Cancer imaging : the official publication of the International Cancer Imaging Society · 2021Article
- Optimization of the differentiation and quantification of high-Z nanoparticles incorporated in medical devices for CT-guided interventions.Medical physics · 2021Article
- Automated classification of solid renal masses on contrast-enhanced computed tomography images using convolutional neural network with decision fusion.European radiology · 2020Article
- Importance of phase enhancement for machine learning classification of solid renal masses using texture analysis features at multi-phasic CT.Abdominal radiology (New York) · 2020Article
- The clinical application value of mixed-reality-assisted surgical navigation for laparoscopic nephrectomy.Cancer medicine · 2020Article
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7 authors.
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Abstract
objectiveThis study aimed to assess material-specific iodine and fat images for diagnosis of clear cell renal cell carcinoma (cc-RCC) compared to papillary RCC (p-RCC) and other renal masses. MATERIALS AND
methodsWith IRB approval, we identified histologically confirmed solid renal masses that underwent rapid-kVp-switch DECT between 2016 and 2018: 25 cc-RCC (7 low grade versus 18 high grade), 11 p-RCC, and 6 other tumors (2 clear cell papillary RCC, 2 chromophobe RCC, 1 oncocytoma, 1 renal angiomyomatous tumor). A blinded radiologist measured iodine and fat concentration on material-specific iodine-water and fat-water basis pair images. Comparisons were performed between groups using univariate analysis and diagnostic accuracy calculated by ROC.
resultsIodine concentration was higher in cc-RCC (6.14 ± 1.79 mg/mL) compared to p-RCC (1.40 ± 0.54 mg/mL, p < 0.001), but not compared to other tumors (5.0 ± 2.2 mg/mL, p = 0.370). Intratumoral fat was seen in 36.0% (9/25) cc-RCC (309.6 ± 234.3 mg/mL [71.1-762.3 ng/mL]), 9.1% (1/11) papillary RCC (97.11 mg/mL), and no other tumors (p = 0.036). Iodine concentration ≥ 3.99 mg/mL achieved AUC and sensitivity/specificity of 0.88 (CI 0.76-1.00) and 92.31%/82.40% to diagnose cc-RCC. To diagnose p-RCC, iodine concentration ≤ 2.5 mg/mL achieved AUC and sensitivity/specificity of 0.99 (0.98-1.00) and 100%/100%. The presence of intratumoral fat had AUC 0.64 (CI 0.53-0.75) and sensitivity/specificity of 34.6%/93.8% to diagnose cc-RCC. A logistic regression model combining iodine concentration and presence of fat increased AUC to 0.91 (CI 0.81-1.0) with sensitivity/specificity of 80.8%/93.8% to diagnose cc-RCC.
conclusionIodine concentration values are highly accurate to differentiate clear cell RCC from papillary RCC; however, they overlap with other tumors. Fat-specific images may improve differentiation of clear cell RCC from other avidly enhancing tumors. KEY POINTS: • Clear cell renal cell carcinoma (RCC) has significantly higher iodine concentration than papillary RCC, but there is an overlap in values comparing clear cell RCC to other renal tumors. • Iodine concentration ≤ 2.5 mg/mL is highly accurate to differentiate papillary RCC from clear cell RCC and other renal tumors. • The presence of microscopic fat on material-specific fat images was specific for clear cell RCC, helping to differentiate clear cell RCC from other avidly enhancing renal tumors.
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