Faculty Collaboration Database

Qualitative assessment of enhancement in a renal mass: contribution of subtraction CT. J Comput Assist Tomogr 2012;36(4):381-7

Date

07/19/2012

Pubmed ID

22805664

DOI

10.1097/RCT.0b013e318256b1ba

Scopus ID

2-s2.0-84863976568 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

PURPOSE: To evaluate the impact of subtraction CT on reader confidence and diagnostic accuracy when characterizing renal masses.

MATERIALS AND METHODS: In this institutional review board-approved retrospective study, 159 patients (85 men and 74 women; mean age, 62.6 years; range, 22-88 years) underwent routine unenhanced and contrast-enhanced multidetector computed tomography (MDCT) for renal lesion characterization. Subtraction images were subsequently generated on scanner console. Two readers independently reviewed the MDCT images to characterize presence of enhancement using a 6-point scale during 3 blinded review sessions of (1) only subtraction, (2) routine, and (3) combined subtraction and routine images. The standard of reference consisted of either histopathology or follow-up imaging and clinical data.

RESULTS: Of the 240 lesions evaluated, 60 lesions (mean, 3.2 cm; range, 1-7.5 cm) were enhancing and 180 lesions (mean, 2.7 cm; range, 0.5-12 cm) were nonenhancing. For determination of lesion enhancement, a combined evaluation of routine MDCT and subtraction images improved reader confidence in 60% to 63% of lesions (P < 0.001). The combined evaluation also provided the highest sensitivity (97%), specificity (99%), and accuracy (98.9%).

CONCLUSION: When used in combination with routine image interpretation, subtraction CT improves reader confidence and diagnostic accuracy in identifying enhancement in renal lesions.

Author List

Kambadakone A, Arasu VA, Samir AE, Eisner BH, Kulkarni NM, Hahn PF, Sahani DV

Author

Naveen Kulkarni MD Assistant Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Contrast Media
Female
Humans
Image Enhancement
Iopamidol
Kidney Neoplasms
Male
Middle Aged
Predictive Value of Tests
Radiographic Image Interpretation, Computer-Assisted
Sensitivity and Specificity
Software
Subtraction Technique
Tomography, X-Ray Computed