Distinction of renal cell carcinomas from high-attenuation renal cysts at portal venous phase contrast-enhanced CT

Michael Suh, Fergus Coakley, Aliya Qayyum, Benjamin M. Yeh, Richard S. Breiman, Ying Lu

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

PURPOSE: To determine if renal cell carcinomas can be distinguished from high-attenuation renal cysts on portal venous phase contrast material-enhanced computed tomographic (CT) scans. MATERIALS AND METHODS: Fifty-seven renal cell carcinomas and 37 high-attenuation (>20 HU) renal cysts that were at least 1 cm in diameter were retrospectively identified in 90 patients who underwent portal venous phase contrast-enhanced CT. Two independent readers recorded the CT number and degree of internal heterogeneity (uniform or mildly, moderately, or markedly heterogeneous) of all lesions. Logistic regression analysis with adjustment for the two readers was used to examine the association between clinical and CT parameters and the final diagnosis. Stepwise logistic regression analysis was used to identify independent distinguishing variables, which were then incorporated in a classification and regression tree analysis to construct the most efficient classification algorithm. RESULTS: Renal cell carcinomas were of significantly greater size (5.10 cm vs 2.84 cm, P <.001), mean attenuation (101.2 HU vs 55.3 HU, P <.001), and internal heterogeneity (P <.001) than high-attenuation renal cysts. Stepwise logistic regression showed attenuation and internal heterogeneity were both independent variables associated with final diagnosis, but lesion size was not an independent distinguishing variable after adjustment for internal heterogeneity. Classification and regression tree analysis demonstrated that an attenuation greater than 70 HU or the presence of moderate or marked internal heterogeneity was an accurate sign of renal cell carcinoma, with a sensitivity of 91% (52 of 57) for both readers and a specificity of 92% (34 of 37) for reader 1 and 84% (31 of 37) for reader 2. CONCLUSION: On portal venous phase contrast-enhanced CT scans, attenuation greater than 70 HU or moderate or marked internal heterogeneity favor a diagnosis of renal cell carcinoma over a diagnosis of high-attenuation renal cyst.

Original languageEnglish (US)
Pages (from-to)330-334
Number of pages5
JournalRadiology
Volume228
Issue number2
DOIs
StatePublished - Aug 1 2003
Externally publishedYes

Fingerprint

Renal Cell Carcinoma
Cysts
Kidney
Regression Analysis
Logistic Models
Contrast Media

Keywords

  • CT
  • Cysts
  • Kidney
  • Kidney neoplasms

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Distinction of renal cell carcinomas from high-attenuation renal cysts at portal venous phase contrast-enhanced CT. / Suh, Michael; Coakley, Fergus; Qayyum, Aliya; Yeh, Benjamin M.; Breiman, Richard S.; Lu, Ying.

In: Radiology, Vol. 228, No. 2, 01.08.2003, p. 330-334.

Research output: Contribution to journalArticle

Suh, Michael ; Coakley, Fergus ; Qayyum, Aliya ; Yeh, Benjamin M. ; Breiman, Richard S. ; Lu, Ying. / Distinction of renal cell carcinomas from high-attenuation renal cysts at portal venous phase contrast-enhanced CT. In: Radiology. 2003 ; Vol. 228, No. 2. pp. 330-334.
@article{92d122bb833a40f3b015b0d02e6f990d,
title = "Distinction of renal cell carcinomas from high-attenuation renal cysts at portal venous phase contrast-enhanced CT",
abstract = "PURPOSE: To determine if renal cell carcinomas can be distinguished from high-attenuation renal cysts on portal venous phase contrast material-enhanced computed tomographic (CT) scans. MATERIALS AND METHODS: Fifty-seven renal cell carcinomas and 37 high-attenuation (>20 HU) renal cysts that were at least 1 cm in diameter were retrospectively identified in 90 patients who underwent portal venous phase contrast-enhanced CT. Two independent readers recorded the CT number and degree of internal heterogeneity (uniform or mildly, moderately, or markedly heterogeneous) of all lesions. Logistic regression analysis with adjustment for the two readers was used to examine the association between clinical and CT parameters and the final diagnosis. Stepwise logistic regression analysis was used to identify independent distinguishing variables, which were then incorporated in a classification and regression tree analysis to construct the most efficient classification algorithm. RESULTS: Renal cell carcinomas were of significantly greater size (5.10 cm vs 2.84 cm, P <.001), mean attenuation (101.2 HU vs 55.3 HU, P <.001), and internal heterogeneity (P <.001) than high-attenuation renal cysts. Stepwise logistic regression showed attenuation and internal heterogeneity were both independent variables associated with final diagnosis, but lesion size was not an independent distinguishing variable after adjustment for internal heterogeneity. Classification and regression tree analysis demonstrated that an attenuation greater than 70 HU or the presence of moderate or marked internal heterogeneity was an accurate sign of renal cell carcinoma, with a sensitivity of 91{\%} (52 of 57) for both readers and a specificity of 92{\%} (34 of 37) for reader 1 and 84{\%} (31 of 37) for reader 2. CONCLUSION: On portal venous phase contrast-enhanced CT scans, attenuation greater than 70 HU or moderate or marked internal heterogeneity favor a diagnosis of renal cell carcinoma over a diagnosis of high-attenuation renal cyst.",
keywords = "CT, Cysts, Kidney, Kidney neoplasms",
author = "Michael Suh and Fergus Coakley and Aliya Qayyum and Yeh, {Benjamin M.} and Breiman, {Richard S.} and Ying Lu",
year = "2003",
month = "8",
day = "1",
doi = "10.1148/radiol.2282020922",
language = "English (US)",
volume = "228",
pages = "330--334",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",

}

TY - JOUR

T1 - Distinction of renal cell carcinomas from high-attenuation renal cysts at portal venous phase contrast-enhanced CT

AU - Suh, Michael

AU - Coakley, Fergus

AU - Qayyum, Aliya

AU - Yeh, Benjamin M.

AU - Breiman, Richard S.

AU - Lu, Ying

PY - 2003/8/1

Y1 - 2003/8/1

N2 - PURPOSE: To determine if renal cell carcinomas can be distinguished from high-attenuation renal cysts on portal venous phase contrast material-enhanced computed tomographic (CT) scans. MATERIALS AND METHODS: Fifty-seven renal cell carcinomas and 37 high-attenuation (>20 HU) renal cysts that were at least 1 cm in diameter were retrospectively identified in 90 patients who underwent portal venous phase contrast-enhanced CT. Two independent readers recorded the CT number and degree of internal heterogeneity (uniform or mildly, moderately, or markedly heterogeneous) of all lesions. Logistic regression analysis with adjustment for the two readers was used to examine the association between clinical and CT parameters and the final diagnosis. Stepwise logistic regression analysis was used to identify independent distinguishing variables, which were then incorporated in a classification and regression tree analysis to construct the most efficient classification algorithm. RESULTS: Renal cell carcinomas were of significantly greater size (5.10 cm vs 2.84 cm, P <.001), mean attenuation (101.2 HU vs 55.3 HU, P <.001), and internal heterogeneity (P <.001) than high-attenuation renal cysts. Stepwise logistic regression showed attenuation and internal heterogeneity were both independent variables associated with final diagnosis, but lesion size was not an independent distinguishing variable after adjustment for internal heterogeneity. Classification and regression tree analysis demonstrated that an attenuation greater than 70 HU or the presence of moderate or marked internal heterogeneity was an accurate sign of renal cell carcinoma, with a sensitivity of 91% (52 of 57) for both readers and a specificity of 92% (34 of 37) for reader 1 and 84% (31 of 37) for reader 2. CONCLUSION: On portal venous phase contrast-enhanced CT scans, attenuation greater than 70 HU or moderate or marked internal heterogeneity favor a diagnosis of renal cell carcinoma over a diagnosis of high-attenuation renal cyst.

AB - PURPOSE: To determine if renal cell carcinomas can be distinguished from high-attenuation renal cysts on portal venous phase contrast material-enhanced computed tomographic (CT) scans. MATERIALS AND METHODS: Fifty-seven renal cell carcinomas and 37 high-attenuation (>20 HU) renal cysts that were at least 1 cm in diameter were retrospectively identified in 90 patients who underwent portal venous phase contrast-enhanced CT. Two independent readers recorded the CT number and degree of internal heterogeneity (uniform or mildly, moderately, or markedly heterogeneous) of all lesions. Logistic regression analysis with adjustment for the two readers was used to examine the association between clinical and CT parameters and the final diagnosis. Stepwise logistic regression analysis was used to identify independent distinguishing variables, which were then incorporated in a classification and regression tree analysis to construct the most efficient classification algorithm. RESULTS: Renal cell carcinomas were of significantly greater size (5.10 cm vs 2.84 cm, P <.001), mean attenuation (101.2 HU vs 55.3 HU, P <.001), and internal heterogeneity (P <.001) than high-attenuation renal cysts. Stepwise logistic regression showed attenuation and internal heterogeneity were both independent variables associated with final diagnosis, but lesion size was not an independent distinguishing variable after adjustment for internal heterogeneity. Classification and regression tree analysis demonstrated that an attenuation greater than 70 HU or the presence of moderate or marked internal heterogeneity was an accurate sign of renal cell carcinoma, with a sensitivity of 91% (52 of 57) for both readers and a specificity of 92% (34 of 37) for reader 1 and 84% (31 of 37) for reader 2. CONCLUSION: On portal venous phase contrast-enhanced CT scans, attenuation greater than 70 HU or moderate or marked internal heterogeneity favor a diagnosis of renal cell carcinoma over a diagnosis of high-attenuation renal cyst.

KW - CT

KW - Cysts

KW - Kidney

KW - Kidney neoplasms

UR - http://www.scopus.com/inward/record.url?scp=0041341835&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0041341835&partnerID=8YFLogxK

U2 - 10.1148/radiol.2282020922

DO - 10.1148/radiol.2282020922

M3 - Article

C2 - 12819331

AN - SCOPUS:0041341835

VL - 228

SP - 330

EP - 334

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 2

ER -