The characterization of small hypoattenuating renal masses on contrast-enhanced CT

Neesha S. Patel, Liina Poder, Zhen J. Wang, Benjamin M. Yeh, Aliya Qayyum, Hua Jin, Fergus V. Coakley

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Purpose: To determine if small hypoattenuating renal masses can be characterized as simple cysts or renal cell carcinomas on contrast-enhanced computed tomography (CT). Materials and methods: We retrospectively identified 20 small (≤1.5 cm) hypoattenuating renal masses seen on contrast enhanced CT, consisting of 14 simple cysts and six renal cell carcinomas. Three independent readers recorded subjective visual impression (five-point scale from 1=definitely fluid to 5=definitely solid), CT attenuation, border (well circumscribed or ill defined), and shape (ovoid or irregular) for each lesion. Results: The overall area under the receiver operator characteristic curves for subjective visual impression, CT attenuation, border, and shape were 0.97, 0.82, 0.59, and 0.55, respectively. Using dichotomized ratings (1-2=cyst and 3-5=carcinoma), subjective impression had a sensitivity and specificity of 100% and 79-100%, respectively, for the diagnosis of renal cell carcinoma. Using a threshold of 50 Hounsfield Units (HU) or more, CT attenuation had a sensitivity and specificity of 100% and 43-64%, respectively. Conclusion: Small hypoattenuating renal masses can be characterized with reasonable accuracy by subjective impression and CT attenuation; lesions that appear solid on visual inspection or have an attenuation value of 50 HU or more are likely to be renal cell carcinoma.

Original languageEnglish (US)
Pages (from-to)295-300
Number of pages6
JournalClinical Imaging
Volume33
Issue number4
DOIs
StatePublished - Jul 1 2009

Keywords

  • CT
  • Computed tomography
  • Contrast enhancement
  • Cysts
  • Kidney
  • Kidney neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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