Aorta-Lesion-Attenuation-Difference (ALAD) on contrast-enhanced CT: a potential imaging biomarker for differentiating malignant from benign oncocytic neoplasms

Objective To evaluate whether the Aorta-Lesion-Attenuation-Difference on contrast-enhanced CT can aid in the differentiation of malignant and benign oncocytic renal neoplasms. Materials and methods Two independent cohorts—an initial (biopsy) dataset and a validation (surgical) dataset—with oncocytom...

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Bibliographic Details
Published in:Abdominal imaging 2017-06, Vol.42 (6), p.1734-1743
Main Authors: Dhyani, Manish, Grajo, Joseph R., Rodriguez, Dayron, Chen, Zhikui, Feldman, Adam, Tambouret, Rosemary, Gervais, Debra A., Arellano, Ronald S., Hahn, Peter F., Samir, Anthony E.
Format: Article
Language:English
Subjects:
Adenoma, Oxyphilic - diagnostic imaging
Adenoma, Oxyphilic - pathology
Adult
Aged
Aged, 80 and over
Aorta
Aorta - diagnostic imaging
Attenuation
Benign
Biomarkers
Biopsy
Carcinoma, Renal Cell - diagnostic imaging
Carcinoma, Renal Cell - pathology
Computed tomography
Confidence intervals
Contrast Media
Coronary vessels
Datasets
Diagnosis, Differential
Diagnostic systems
Differentiation
Female
Gastroenterology
Hepatology
Humans
Image processing
Imaging
Kidney cancer
Kidney Neoplasms - diagnostic imaging
Kidney Neoplasms - pathology
Kidneys
Male
Mathematical analysis
Medicine
Medicine & Public Health
Middle Aged
Neoplasms
Radiology
Renal cell carcinoma
Retrospective Studies
Reviews
Sensitivity
Sensitivity and Specificity
Statistical analysis
Surgery
Tomography, X-Ray Computed - methods
Tumors
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Summary:Objective To evaluate whether the Aorta-Lesion-Attenuation-Difference on contrast-enhanced CT can aid in the differentiation of malignant and benign oncocytic renal neoplasms. Materials and methods Two independent cohorts—an initial (biopsy) dataset and a validation (surgical) dataset—with oncocytomas and chromophobe renal cell carcinomas (chRCC) were included in this IRB-approved retrospective study. A region of interest was placed on the renal mass and abdominal aorta on the same CT image slice to calculate an Aorta-Lesion-Attenuation-Difference (ALAD). ROC curves were plotted for different enhancement phases, and diagnostic performance of ALAD for differentiating chRCC from oncocytomas was calculated. Results Seventy-nine renal masses (56 oncocytomas, 23 chRCC) were analyzed in the initial (biopsy) dataset. Thirty-six renal masses (16 oncocytomas, 20 chRCC) were reviewed in the validation (surgical) cohort. ALAD showed a statistically significant difference between oncocytomas and chromophobes during the nephrographic phase ( p  
ISSN:2366-004X
2366-0058
DOI:10.1007/s00261-017-1061-3