ArticleThe Pan African medical journal2026
Tumor heterogeneity on contrast-enhanced computed tomography outperforms attenuation ratio in differentiating renal cell carcinoma subtypes: a pathologic correlation study.
Article in The Pan African medical journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: malignant renal masses are frequently identified on computed tomography (CT) in clinical practice; however, noninvasive differentiation between renal mass subtypes, including renal cell carcinoma (RCC) and non-RCC lesions, remains challenging. Methods: this cross-sectional study included patients undergoing nephrectomy who had preoperative CT imaging and histopathologic evaluation. The attenuation ratio was defined as the ratio of Hounsfield Unit (HU) values between the tumor and the renal cortex. Tumor heterogeneity was independently assessed on a 5-point Likert scale during the corticomedullary phase. Results: there was no significant difference in attenuation ratio between the RCC and non-RCC groups (p>0.05), whereas the heterogeneity score of renal masses on CT scans was significantly higher in RCC than in non-RCC masses (P<0.05), reflecting the tumor's structural complexity and aggressiveness. Conclusion: our findings indicate that mass heterogeneity may outperform the attenuation ratio as a diagnostic and prognostic indicator in distinguishing malignant renal mass subtypes. Assessment of heterogeneity on preoperative CT thus holds promise as a valuable radiologic biomarker and may contribute to optimized treatment planning. Larger-scale studies are needed to further substantiate these results.
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