Although differentiation between benign and malignant small renal tumors (≤4 cm) is still difficult, it is a demand for decision making and determining the treatment strategy. Our aim is to evaluate the role of multidetector row computed tomography (MDCT) in the differentiation of small renal clear cell carcinoma (RCC) and renal oncocytoma (RO).
We reviewed triphasic computed tomographic (CT) scans performed in 43 patients diagnosed with RCC (n = 23) and RO (n = 21). After an unenhanced CT phase of the upper abdomen, triple-phase acquisition included a cortico-medullary phase (CMP), a nephrographic phase (NP), and a pyelographic phase (PP), and lesions were evaluated both qualitatively and quantitatively.
RCCs were hypervascular in 13 cases and hypovascular in 10 cases, while ROs were hypervascular in nine cases and hypovascular in 12 cases. Mean attenuation values (MAVs) for hypervascular RCCs and hypervascular ROs on unenhanced examination were 34.0 ± 7.1 and 31.3 ± 8.1 HU, respectively. Enhancement in CMP was 173.1 ± 45.2 HU for RCCs and 151.1 ± 36.0 HU for ROs and a gradual wash-out in NP (148.8 ± 34.3 and 137.1 ± 33.9 HU for RCCs and ROs, respectively) and in PP (98.2 ± 36.0 HU for RCCs and 79.4 ± 21.5 HU for ROs) was observed. MAV for hypovascular RCCs and hypovascular ROs on unenhanced examination were 32.4 ± 12.0 and 28.9 ± 8.0 HU, respectively. Both hypovascular RCCs and ROs showed a statistically significant difference in each post contrastographic phase.
Absolute attenuation and the quantitative amount of the enhancement were not strong predictors for RO and RCC differentiation.
Urologia 2017; 84(4): 244 - 250
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsMichele Scialpi, Eugenio Martorana, Valeria Rondoni, Ahmed Eissa, Ahmed El Sherbiny, Luigi Bevilacqua, Luis H. Ros, Irene Escartín Martínez, Michele Milizia, Lucia Manganaro, Maria Antonietta Mazzei, Alfredo D’Andrea, Giampaolo Bianchi
- • Accepted on 09/06/2017
- • Available online on 11/08/2017
- • Published in print on 25/10/2017
This article is available as full text PDF.
- Scialpi, Michele [PubMed] [Google Scholar] 1, * Corresponding Author (email@example.com)
- Martorana, Eugenio [PubMed] [Google Scholar] 2
- Rondoni, Valeria [PubMed] [Google Scholar] 1
- Eissa, Ahmed [PubMed] [Google Scholar] 2, 3
- Sherbiny, Ahmed El [PubMed] [Google Scholar] 2, 3
- Bevilacqua, Luigi [PubMed] [Google Scholar] 2
- Ros, Luis H. [PubMed] [Google Scholar] 4
- Escartín Martínez, Irene [PubMed] [Google Scholar] 4
- Milizia, Michele [PubMed] [Google Scholar] 1
- Manganaro, Lucia [PubMed] [Google Scholar] 5
- Mazzei, Maria Antonietta [PubMed] [Google Scholar] 6
- D’Andrea, Alfredo [PubMed] [Google Scholar] 7
- Bianchi, Giampaolo [PubMed] [Google Scholar] 2
Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, S. Andrea delle Fratte, Perugia - Italy
Department of Urology, University of Modena and Reggio Emilia, Modena - Italy
Department of Urology, Faculty of Medicine, Tanta University, Tanta - Egypt
Department of Radiology, University Hospital Miguel Servet, Zaragoza - Spain
Department of Radiologic, Oncologic and Pathologic Sciences, Sapienza University, Rome - Italy
Department of Radiology, University of Siena, Siena - Italy
Medical-Surgical Department of Internal, Clinical and Experimental Medicine “F. Magrassi and A. Lanzara”, University of Campania, Second University of Naples “Luigi Vanvitelli”, Caserta - Italy