Comparison of Iodine Quantification and Conventional Attenuation Measurements for Differentiating Small, Truly Enhancing Renal Masses From High-Attenuation Nonenhancing Renal Lesions With Dual-Energy CT

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dc.contributor.authorMeyer, Mathias
dc.contributor.authorNelson, Rendon
dc.contributor.authorVernuccio, Federica
dc.contributor.authorGonzález, Fernando
dc.contributor.authorSchabel, Christoph
dc.contributor.authorMileto, Achille
dc.contributor.authorPatel, Bhavik
dc.contributor.authorSchoenberg, Stefan
dc.contributor.authorMarin, Daniele
dc.date.accessioned2022-06-29T20:46:52Z
dc.date.available2022-06-29T20:46:52Z
dc.date.issued2019
dc.description.abstractOBJECTIVE. The purpose of this study is to determine whether iodine quantification techniques from contrast-enhanced dual-energy CT (DECT) data allow equal differentiation of small enhancing renal masses from high-attenuation (> 20 HU of unenhanced attenuation) nonenhancing lesions, compared with conventional attenuation measurements. MATERIALS AND METHODS. A total of 220 nonconsecutive patients (mean [± SD] age, 66 ± 13 years; 130 men and 90 women) with 265 high-attenuation renal lesions (mean attenuation, 54 ± 33 HU; 91 enhancing lesions) were included. Each patient underwent single-energy unenhanced CT followed by DECT during the nephrographic phase using one of four different high-end DECT platforms (first- and second-generation rapid-kilovoltage-switching DECT platforms and second- and third-generation dual-source DECT platforms). Iodine quantification measurements and conventional attenuation change measurements were calculated for each lesion. Diagnostic accuracy was determined by pathologic analysis, confirmation with another imaging modality, or greater than 24 months of imaging follow-up as the reference standard. RESULTS. The diagnostic accuracy for differentiating enhancing from nonenhancing renal lesions was significantly higher for conventional attenuation change measurements, compared with iodine quantification measurements (AUC values, 0.973 vs 0.875; p < 0.0001). The diagnostic performance of iodine quantification measurements improved only marginally with the utilization of DECT platform-specific optimized iodine quantification thresholds, yielding AUC values of 0.907 and 0.893 for the rapid-kilovoltage-switching DECT and dual-source DECT platforms, respectively. Unenhanced lesion attenuation (p = 0.0010) and intraparenchymal location (p = 0.0249) significantly influenced the diagnostic accuracy of the iodine quantification techniques. CONCLUSION. Iodine quantification from DECT data yields inferior diagnostic accuracy when compared with conventional attenuation change measurements for differentiating small, truly enhancing renal masses and high-attenuation renales
dc.description.versionVersión publicadaes
dc.identifier.citationMeyer M, Nelson RC, Vernuccio F, Gonzalez F, Schabel C, Mileto A, Patel BN, Schoenberg SO, Marin D. Comparison of Iodine Quantification and Conventional Attenuation Measurements for Differentiating Small, Truly Enhancing Renal Masses From High-Attenuation Nonenhancing Renal Lesions With Dual-Energy CT. AJR Am J Roentgenol. 2019 Jul;213(1):W26-W37. doi: 10.2214/AJR.18.20547es
dc.identifier.urihttps://doi.org/10.2214/AJR.18.20547es
dc.identifier.urihttp://hdl.handle.net/11447/6271
dc.language.isoenes
dc.subjectDual energyes
dc.subjectEnhancementes
dc.subjectIodine quantificationes
dc.subjectRenal lesiones
dc.titleComparison of Iodine Quantification and Conventional Attenuation Measurements for Differentiating Small, Truly Enhancing Renal Masses From High-Attenuation Nonenhancing Renal Lesions With Dual-Energy CTes
dc.typeArticlees
dcterms.sourceAJR. American journal of roentgenologyes

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