Comparison of iodine quantification and conventional attenuation measurements for differentiating small, truly enhancing renal masses from high-attenuation nonenhancing renal lesions with dual-energy CT

Federica Vernuccio, Federica Vernuccio, Stefan O. Schoenberg, Achille Mileto, Christoph Schabel, Mathias Meyer, Rendon C. Nelson, Bhavik N. Patel, Fernando Gonzalez, Daniele Marin

Risultato della ricerca: Article

2 Citazioni (Scopus)

Abstract

OBJECTIVE. The purpose of this study is to determine whether iodine quantification techniques from contrast-enhanced dual-energy CT (DECT) data allow equal differentiation of small enhancing renal masses from high-attenuation (> 20 HU of unenhanced attenuation) nonenhancing lesions, compared with conventional attenuation measurements. MATERIALS AND METHODS. A total of 220 nonconsecutive patients (mean [± SD] age, 66 ± 13 years; 130 men and 90 women) with 265 high-attenuation renal lesions (mean attenuation, 54 ± 33 HU; 91 enhancing lesions) were included. Each patient underwent single-energy unenhanced CT followed by DECT during the nephrographic phase using one of four different high-end DECT platforms (first- and second-generation rapid-kilovoltage-switching DECT platforms and second- and third-generation dual-source DECT platforms). Iodine quantification measurements and conventional attenuation change measurements were calculated for each lesion. Diagnostic accuracy was determined by pathologic analysis, confirmation with another imaging modality, or greater than 24 months of imaging follow-up as the reference standard. RESULTS. The diagnostic accuracy for differentiating enhancing from nonenhancing renal lesions was significantly higher for conventional attenuation change measurements, compared with iodine quantification measurements (AUC values, 0.973 vs 0.875; p < 0.0001). The diagnostic performance of iodine quantification measurements improved only marginally with the utilization of DECT platform–specific optimized iodine quantification thresholds, yielding AUC values of 0.907 and 0.893 for the rapid-kilovoltage-switching DECT and dual-source DECT platforms, respectively. Unenhanced lesion attenuation (p = 0.0010) and intraparenchymal location (p = 0.0249) significantly influenced the diagnostic accuracy of the iodine quantification techniques. CONCLUSION. Iodine quantification from DECT data yields inferior diagnostic accuracy when compared with conventional attenuation change measurements for differentiating small, truly enhancing renal masses and high-attenuation renal lesions.
Lingua originaleEnglish
pagine (da-a)W1-W11
Numero di pagine11
RivistaAmerican Journal of Roentgenology
Volume213
Stato di pubblicazionePublished - 2019

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Iodine
Kidney
Area Under Curve

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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Comparison of iodine quantification and conventional attenuation measurements for differentiating small, truly enhancing renal masses from high-attenuation nonenhancing renal lesions with dual-energy CT. / Vernuccio, Federica; Vernuccio, Federica; Schoenberg, Stefan O.; Mileto, Achille; Schabel, Christoph; Meyer, Mathias; Nelson, Rendon C.; Patel, Bhavik N.; Gonzalez, Fernando; Marin, Daniele.

In: American Journal of Roentgenology, Vol. 213, 2019, pag. W1-W11.

Risultato della ricerca: Article

Vernuccio, Federica ; Vernuccio, Federica ; Schoenberg, Stefan O. ; Mileto, Achille ; Schabel, Christoph ; Meyer, Mathias ; Nelson, Rendon C. ; Patel, Bhavik N. ; Gonzalez, Fernando ; Marin, Daniele. / Comparison of iodine quantification and conventional attenuation measurements for differentiating small, truly enhancing renal masses from high-attenuation nonenhancing renal lesions with dual-energy CT. In: American Journal of Roentgenology. 2019 ; Vol. 213. pagg. W1-W11.
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title = "Comparison of iodine quantification and conventional attenuation measurements for differentiating small, truly enhancing renal masses from high-attenuation nonenhancing renal lesions with dual-energy CT",
abstract = "OBJECTIVE. The purpose of this study is to determine whether iodine quantification techniques from contrast-enhanced dual-energy CT (DECT) data allow equal differentiation of small enhancing renal masses from high-attenuation (> 20 HU of unenhanced attenuation) nonenhancing lesions, compared with conventional attenuation measurements. MATERIALS AND METHODS. A total of 220 nonconsecutive patients (mean [± SD] age, 66 ± 13 years; 130 men and 90 women) with 265 high-attenuation renal lesions (mean attenuation, 54 ± 33 HU; 91 enhancing lesions) were included. Each patient underwent single-energy unenhanced CT followed by DECT during the nephrographic phase using one of four different high-end DECT platforms (first- and second-generation rapid-kilovoltage-switching DECT platforms and second- and third-generation dual-source DECT platforms). Iodine quantification measurements and conventional attenuation change measurements were calculated for each lesion. Diagnostic accuracy was determined by pathologic analysis, confirmation with another imaging modality, or greater than 24 months of imaging follow-up as the reference standard. RESULTS. The diagnostic accuracy for differentiating enhancing from nonenhancing renal lesions was significantly higher for conventional attenuation change measurements, compared with iodine quantification measurements (AUC values, 0.973 vs 0.875; p < 0.0001). The diagnostic performance of iodine quantification measurements improved only marginally with the utilization of DECT platform–specific optimized iodine quantification thresholds, yielding AUC values of 0.907 and 0.893 for the rapid-kilovoltage-switching DECT and dual-source DECT platforms, respectively. Unenhanced lesion attenuation (p = 0.0010) and intraparenchymal location (p = 0.0249) significantly influenced the diagnostic accuracy of the iodine quantification techniques. CONCLUSION. Iodine quantification from DECT data yields inferior diagnostic accuracy when compared with conventional attenuation change measurements for differentiating small, truly enhancing renal masses and high-attenuation renal lesions.",
author = "Federica Vernuccio and Federica Vernuccio and Schoenberg, {Stefan O.} and Achille Mileto and Christoph Schabel and Mathias Meyer and Nelson, {Rendon C.} and Patel, {Bhavik N.} and Fernando Gonzalez and Daniele Marin",
year = "2019",
language = "English",
volume = "213",
pages = "W1--W11",
journal = "American Journal of Roentgenology",
issn = "0361-803X",
publisher = "American Roentgen Ray Society",

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TY - JOUR

T1 - Comparison of iodine quantification and conventional attenuation measurements for differentiating small, truly enhancing renal masses from high-attenuation nonenhancing renal lesions with dual-energy CT

AU - Vernuccio, Federica

AU - Vernuccio, Federica

AU - Schoenberg, Stefan O.

AU - Mileto, Achille

AU - Schabel, Christoph

AU - Meyer, Mathias

AU - Nelson, Rendon C.

AU - Patel, Bhavik N.

AU - Gonzalez, Fernando

AU - Marin, Daniele

PY - 2019

Y1 - 2019

N2 - OBJECTIVE. The purpose of this study is to determine whether iodine quantification techniques from contrast-enhanced dual-energy CT (DECT) data allow equal differentiation of small enhancing renal masses from high-attenuation (> 20 HU of unenhanced attenuation) nonenhancing lesions, compared with conventional attenuation measurements. MATERIALS AND METHODS. A total of 220 nonconsecutive patients (mean [± SD] age, 66 ± 13 years; 130 men and 90 women) with 265 high-attenuation renal lesions (mean attenuation, 54 ± 33 HU; 91 enhancing lesions) were included. Each patient underwent single-energy unenhanced CT followed by DECT during the nephrographic phase using one of four different high-end DECT platforms (first- and second-generation rapid-kilovoltage-switching DECT platforms and second- and third-generation dual-source DECT platforms). Iodine quantification measurements and conventional attenuation change measurements were calculated for each lesion. Diagnostic accuracy was determined by pathologic analysis, confirmation with another imaging modality, or greater than 24 months of imaging follow-up as the reference standard. RESULTS. The diagnostic accuracy for differentiating enhancing from nonenhancing renal lesions was significantly higher for conventional attenuation change measurements, compared with iodine quantification measurements (AUC values, 0.973 vs 0.875; p < 0.0001). The diagnostic performance of iodine quantification measurements improved only marginally with the utilization of DECT platform–specific optimized iodine quantification thresholds, yielding AUC values of 0.907 and 0.893 for the rapid-kilovoltage-switching DECT and dual-source DECT platforms, respectively. Unenhanced lesion attenuation (p = 0.0010) and intraparenchymal location (p = 0.0249) significantly influenced the diagnostic accuracy of the iodine quantification techniques. CONCLUSION. Iodine quantification from DECT data yields inferior diagnostic accuracy when compared with conventional attenuation change measurements for differentiating small, truly enhancing renal masses and high-attenuation renal lesions.

AB - OBJECTIVE. The purpose of this study is to determine whether iodine quantification techniques from contrast-enhanced dual-energy CT (DECT) data allow equal differentiation of small enhancing renal masses from high-attenuation (> 20 HU of unenhanced attenuation) nonenhancing lesions, compared with conventional attenuation measurements. MATERIALS AND METHODS. A total of 220 nonconsecutive patients (mean [± SD] age, 66 ± 13 years; 130 men and 90 women) with 265 high-attenuation renal lesions (mean attenuation, 54 ± 33 HU; 91 enhancing lesions) were included. Each patient underwent single-energy unenhanced CT followed by DECT during the nephrographic phase using one of four different high-end DECT platforms (first- and second-generation rapid-kilovoltage-switching DECT platforms and second- and third-generation dual-source DECT platforms). Iodine quantification measurements and conventional attenuation change measurements were calculated for each lesion. Diagnostic accuracy was determined by pathologic analysis, confirmation with another imaging modality, or greater than 24 months of imaging follow-up as the reference standard. RESULTS. The diagnostic accuracy for differentiating enhancing from nonenhancing renal lesions was significantly higher for conventional attenuation change measurements, compared with iodine quantification measurements (AUC values, 0.973 vs 0.875; p < 0.0001). The diagnostic performance of iodine quantification measurements improved only marginally with the utilization of DECT platform–specific optimized iodine quantification thresholds, yielding AUC values of 0.907 and 0.893 for the rapid-kilovoltage-switching DECT and dual-source DECT platforms, respectively. Unenhanced lesion attenuation (p = 0.0010) and intraparenchymal location (p = 0.0249) significantly influenced the diagnostic accuracy of the iodine quantification techniques. CONCLUSION. Iodine quantification from DECT data yields inferior diagnostic accuracy when compared with conventional attenuation change measurements for differentiating small, truly enhancing renal masses and high-attenuation renal lesions.

UR - http://hdl.handle.net/10447/366856

UR - https://www.ajronline.org/doi/pdf/10.2214/AJR.18.20547

M3 - Article

VL - 213

SP - W1-W11

JO - American Journal of Roentgenology

JF - American Journal of Roentgenology

SN - 0361-803X

ER -