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Delayed computed tomographic characterization of renal masses: preliminary experience
S L Voci1, R H Gottlieb, P J Fultz
1Department of Radiology, University of Rochester Medical Center, NY 14642, USA.
Abdominal Imaging
|May 24, 2000
Summary
Delayed contrast-enhanced computed tomography (DCT) effectively differentiates renal cell carcinomas from benign cysts. This imaging technique aids in characterizing incidental renal lesions found on postcontrast CT scans.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Evaluating the diagnostic performance of delayed contrast-enhanced computed tomography (DCT) for characterizing renal masses.
- Assessing the utility of DCT in differentiating between neoplastic and non-neoplastic renal lesions.
Purpose of the Study:
- To determine the effectiveness of DCT in characterizing renal masses.
- To compare the performance of DCT with conventional contrast-enhanced CT in identifying renal tumors.
Main Methods:
- Prospective evaluation of 24 patients with suspected or indeterminate renal masses.
- Comparison of precontrast, conventional contrast-enhanced CT (2-min delay), and delayed contrast-enhanced CT (13-min delay).
- Analysis of lesions >1.0 cm with constant scanning parameters.
Main Results:
- Delayed contrast-enhanced CT detected all 6 pathologically confirmed renal cell carcinomas (RCCs) using a 10 Hounsfield unit (HU) attenuation decrease threshold.
- Significant attenuation decrease observed in RCCs (mean 29.6 HU) compared to non-neoplastic cysts (mean 1.1 HU) (p=0.031).
- DCT correctly classified 94% (32/34) of non-neoplastic renal cysts.
Conclusions:
- Delayed contrast-enhanced CT demonstrates high accuracy in distinguishing renal cell carcinomas from non-neoplastic cysts.
- DCT shows potential as a valuable tool for characterizing incidentally discovered renal lesions on postcontrast CT.
- The study supports the use of DCT for improved diagnostic confidence in renal mass evaluation.