Iodine quantification to distinguish clear cell from papillary renal cell carcinoma at dual-energy multidetector CT: a multireader diagnostic performance study.
Radiology
; 273(3): 813-20, 2014 Dec.
Article
em En
| MEDLINE
| ID: mdl-25162309
ABSTRACT
PURPOSE:
To investigate whether dual-energy multidetector row computed tomographic (CT) imaging with iodine quantification is able to distinguish between clear cell and papillary renal cell carcinoma ( RCC renal cell carcinoma ) subtypes. MATERIALS ANDMETHODS:
In this retrospective, HIPAA-compliant, institutional review board-approved study, 88 patients (57 men, 31 women) with diagnosis of either clear cell or papillary RCC renal cell carcinoma at pathologic analysis, who underwent contrast material-enhanced dual-energy nephrographic phase study between December 2007 and June 2013, were included. Five readers, blinded to pathologic diagnosis, independently evaluated all cases by determining the lesion iodine concentration on color-coded iodine maps. The receiving operating characteristic curve analysis was adopted to estimate the optimal threshold for discriminating between clear cell and papillary RCC renal cell carcinoma , and results were validated by using a leave-one-out cross-validation. Interobserver agreement was assessed by using an intraclass correlation coefficient. The correlation between tumor iodine concentration and tumor grade was investigated.RESULTS:
A tumor iodine concentration of 0.9 mg/mL represented the optimal threshold to discriminate between clear cell and papillary RCC renal cell carcinoma , and it yielded the following sensitivity, 98.2% (987 of 1005 [95% confidence interval 97.7%, 98.7%]); specificity, 86.3% (272 of 315 [95% confidence interval 85.0%, 87.7%]); positive predictive value, 95.8% (987 of 1030 [95% confidence interval 95.0%, 96.6%]); negative predictive value, 93.7% (272 of 290 [95% confidence interval 92.8%, 94.7%]); overall accuracy of 95.3% (1259 of 1320 [95% confidence interval 94.6%, 96.2%]), with an area under the curve of 0.923 (95% confidence interval 0.913, 0.933). An excellent agreement was found among the five readers in measured tumor iodine concentration (intraclass correlation coefficient, 0.9990 [95% confidence interval 0. 9987, 0.9993). A significant correlation was found between tumor iodine concentration and tumor grade for both clear cell (τ = 0.85; P < .001) and papillary RCC renal cell carcinoma (τ = 0.53; P < .001).CONCLUSION:
Dual-energy multidetector CT with iodine quantification can be used to distinguish between clear cell and papillary RCC renal cell carcinoma , and it provides insights regarding the tumor grade.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Carcinoma Papilar
/
Carcinoma de Células Renais
/
Tomografia Computadorizada Multidetectores
/
Neoplasias Renais
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article