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Voxel-based whole-lesion enhancement parameters: a study of its clinical value in differentiating clear cell renal cell carcinoma from renal oncocytoma

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Abstract

Purpose

The purpose of this study was to compare whole-lesion (WL) enhancement parameters to single region of interest (ROI)-based enhancement in discriminating clear cell renal cell carcinoma (ccRCC) from renal oncocytoma.

Materials and Methods

In this IRB-approved retrospective study, the surgical database was queried to derive a cohort of 94 postnephrectomy patients with ccRCC or oncocytoma (68 ccRCC, 26 oncocytoma), who underwent preoperative multiphase contrast-enhanced computed tomography (CECT) between June 2009 and August 2013. CT acquisitions were transferred to a three-dimensional workstation, and WL ROIs were manually segmented. WL enhancement and histogram distribution parameters skewness, kurtosis, standard deviation (SD), and interquartile range (IQR) were calculated. WL enhancement parameters were compared to single ROI-based enhancement using receiver operating characteristic (ROC) analysis.

Results

Oncocytoma had significantly higher WL enhancement than ccRCC in nephrographic (mean, p = 0.02; median, p = 0.03) and excretory phases (mean, p = 0.03; median p < 0.01). ccRCC had significantly higher kurtosis than oncocytoma in corticomedullary (p = 0.03) and excretory phases (p < 0.01), and significantly higher SD and IQR than oncocytoma in all postcontrast phases: corticomedullary (SD, p = 0.02; IQR, p < 0.01), nephrographic (SD, p = 0.01; IQR, p = 0.03), and excretory (SD, p < 0.01; IQR, p < 0.01). When compared to single ROI-based enhancement, WL enhancement alone did not demonstrate a statistical advantage in discriminating between ccRCC and oncocytoma (area under ROC curve of 0.78 and 0.72 respectively), but when combined with histogram distribution parameters (area under ROC curve of 0.86), it did demonstrate a slight improvement.

Conclusion

Our study suggests that voxel-based WL enhancement parameters provide only a slight improvement over single ROI-based enhancement techniques in differentiating between ccRCC and renal oncocytoma.

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Authors and Affiliations

  1. Keck School of Medicine, University of Southern California, 1500 San Pablo St, 2nd Floor Imaging, Los Angeles, CA, 90033, USA

    Frank Chen, Mittul Gulati, Darryl Hwang, Steven Cen, Felix Yap, Chidubem Ugwueze, Bino Varghese, Mihir Desai, Manju Aron, Inderbir Gill & Vinay Duddalwar

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  1. Frank Chen
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  2. Mittul Gulati
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  3. Darryl Hwang
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Correspondence to Frank Chen.

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Funding

This project has received funding from the Whittier foundation. The project described was supported in part by the Award Number P30CA014089 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

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None of the authors have any conflict of interest to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Chen, F., Gulati, M., Hwang, D. et al. Voxel-based whole-lesion enhancement parameters: a study of its clinical value in differentiating clear cell renal cell carcinoma from renal oncocytoma. Abdom Radiol 42, 552–560 (2017). https://doi.org/10.1007/s00261-016-0891-8

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