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In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
Published on: March 30, 2015
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CT imaging of solid renal masses: pitfalls and solutions
S Krishna1, C A Murray1, M D McInnes1
1Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
Clinical Radiology
|June 9, 2017
Summary
Computed tomography (CT) has limitations in evaluating renal masses. Recognizing pitfalls in CT scans, like interpreting lesion enhancement and using dual-energy CT (DECT), improves diagnostic accuracy for kidney tumors.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Computed tomography (CT) is the primary imaging modality for renal mass characterization.
- Unrecognized CT limitations can lead to diagnostic errors in evaluating solid renal masses.
Purpose of the Study:
- To present ten common pitfalls encountered during CT evaluation of solid renal masses.
- To highlight strategies for accurate diagnosis and differentiation of renal lesions using CT.
Main Methods:
- Review of CT imaging characteristics of various renal masses.
- Discussion of diagnostic criteria for angiomyolipoma (AML) and renal cell carcinoma (RCC).
- Exploration of dual-energy CT (DECT) applications for improved lesion characterization.
Main Results:
- Specific CT attenuation values and enhancement patterns are crucial for differentiating benign from malignant renal lesions.
- Macroscopic fat on non-contrast enhanced CT (NECT) is diagnostic for AML.
- DECT offers advanced characterization capabilities, including virtual NECT and quantitative iodine analysis, to resolve indeterminate lesions.
Conclusions:
- Awareness of CT pitfalls, such as cyst pseudo-enhancement and low-dose technique artifacts, is essential for accurate renal mass assessment.
- DECT and other advanced imaging techniques can overcome limitations of conventional CT.
- Accurate CT interpretation improves the management of patients with renal masses.
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