ArticleKorean journal of radiology2025
Peritumoral Cortex Low-Enhancement Sign on Corticomedullary Phase CT: A Distinctive Indicator of Small Renal Malignancies.
Article in Korean journal of radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Development and validation of a deep learning radiomics model for predicting capsular invasion in small renal masses: a multicenter retrospective study.Quantitative imaging in medicine and surgery · 2026Article
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10 authors.
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Abstract
objectiveTo retrospectively evaluate the diagnostic potential of the peritumoral cortex low-enhancement (PCLE) sign on corticomedullary phase (CMP) CT images for differentiating malignant from benign lesions and clear cell renal cell carcinoma (ccRCC) from non-ccRCC among small renal masses (SRMs, ≤4 cm). MATERIALS AND
methodsAfter excluding cases with incomplete/poor-quality CT images and SRMs exhibiting cystic changes, visible fat, or infiltrative/completely endophytic/exophytic growth patterns, 603 histopathologically confirmed SRMs (507 malignant and 96 benign; 409 ccRCC and 194 non-ccRCC) from 595 patients across three institutions were retrospectively analyzed using thin-slice CT images (≤1.5 mm). PCLE was defined as a focal low-enhancement region of the peritumoral cortex at the tumor-cortex interface on CMP CT images, similar to the early dark cortical band sign. Diagnostic performance of PCLE for malignancy and ccRCC was evaluated. A separate cohort of 109 SRMs (91 malignant and 18 benign; 77 ccRCCs and 32 non-ccRCCs) from 108 patients, imaged with thick-slice CT (3 mm), was additionally analyzed using otherwise the same methodology.
resultsPCLE was identified in 331 SRMs (54.9%, 331/603), including 326 malignant and 5 benign SRMs (all oncocytomas >3 cm), and in 307 ccRCC and 24 non-ccRCC SRMs. For diagnosing malignant SRMs, PCLE demonstrated a sensitivity of 64.3% (326/507) and specificity of 94.8% (91/96). For ccRCCs, these values were 75.1% (307/409) and 87.6% (170/194), respectively. In tumors ≤3 cm, specificity reached 100% (78/78) for malignancies and 93.5% (129/138) for ccRCCs. Inter-observer agreement for PCLE was substantial (Cohen's kappa, 0.783). Findings from the thick-slice cohort closely mirrored those in the primary cohort obtained using thin-slice CT images.
conclusionPCLE observed on CMP CT demonstrated exceptional specificity for malignant and ccRCC among SRMs, especially in SRMs ≤3 cm, though sensitivity was limited, and false positives occurred in oncocytomas.
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