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Differentiation between renal oncocytomas and chromophobe renal cell carcinomas using dynamic contrast-enhanced computed tomography

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the ability of inferior vena cava-lesion-attenuation-difference (ILAD) and lesion-cortex-attenuation-ratio (LCAR) to differentiate renal oncocytomas (RO) from chromophobe renal cell carcinomas (chRCC).

Methods

Retrospective study with analysis of 84 cases of chRCC and 30 cases of RO confirmed by surgical pathology. ILAD was calculated by measuring the difference in Hounsfield units (HU) between the inferior vena cava and the lesion of interest on the same image slice on preoperative CT scan. Calculating LCAR using the CT attenuation ratio of lesion to renal cortex at the same image slice. Receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic values of ILAD and LCAR for disease activity.

Results

There were no statistically significant differences in demographic and lesion characteristics between patients with chRCC and RO (p > 0.05). ILAD has significant statistical differences in the identification of RO and chRCC in the arterial (p = 0.031), venous (p = 0.047), and delayed phase (p = 0.002). And LCAR showed a statistically significant difference between two lesions during the arterial (p = 0.043), venous (p = 0.026), and delayed phase (p = 0.008). When all significant variables were used in combination to build a predicting model (Mix), the AUC was 0.871 (95% CI 0.759–0.984) with 67.9% sensitivity and 100% specificity.

Conclusion

ILAD and LCAR at the arterial phase, venous phase and delayed phase were shown to be useful CT attenuation parameter in discriminating RO from chRCC when histologic evaluation on biopsy is indeterminate.

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Data availability

All data and material are fully available without restriction.

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Acknowledgements

The author thanks Shuai Ren, Huifeng Zhang for providing language help and Yingying Cao, Yaping Zhang, Xiaoyu Gu for data analysis. This study was supported by the Key Program of Research and Development of Jiangsu Province (BE2017772) and the National Natural Science Foundation of China (81771899).

Funding

This study was supported by the Key Program of Research and Development of Jiangsu Province (BE2017772) and the National Natural Science Foundation of China (81771899).

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Authors and Affiliations

  1. Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 Hanzhong Road, Nanjing, 210029, Jiangsu, China

    Kai Guo, Shuai Ren, Yingying Cao, Huifeng Zhang, Yaping Zhang, Xiaoyu Gu & Zhongqiu Wang

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  1. Kai Guo
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  2. Shuai Ren
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Contributions

KG: guarantor of integrity of the entire study. ZW, KG: study concepts and design. KG, YC, YZ, XG: literature research. HZ, KG: clinical studies. SR, KG: data statistical analysis. KG, SR: manuscript preparation. KG: manuscript editing.

Corresponding author

Correspondence to Zhongqiu Wang.

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The authors report no other potential conflicts of interest.

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This study was approved by the institutional review board of the Affiliated Hospital of Nanjing University of Chinese Medicine and patient informed consent was waived due to its retrospective nature.

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Formal ethics approval and consent to participate was not required in this retrospective analysis of observational data.

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Guo, K., Ren, S., Cao, Y. et al. Differentiation between renal oncocytomas and chromophobe renal cell carcinomas using dynamic contrast-enhanced computed tomography. Abdom Radiol 46, 3309–3316 (2021). https://doi.org/10.1007/s00261-021-03018-7

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