Wang Dan, Huang Xiaoyu, Bai Liangcai, Zhang Xueling, Wei Jinyan, Zhou Junlin
Department of Radiology, 74713Lanzhou University Second Hospital, Lanzhou, PR China.
Acta Radiol. 2020 Nov;61(11):1562-1569. doi: 10.1177/0284185120903447. Epub 2020 Feb 23.
Computed tomography (CT) image features of chromophobe renal cell carcinoma (ChRCC) and papillary renal cell carcinoma (PRCC) are, occasionally, sometimes difficult to identify. However, spectral CT might provide quantitative parameters to differentiate them.
To differentiate between ChRCC and PRCC with quantitative parameters using spectral CT.
Forty cases of RCC confirmed with pathological tests were analyzed retrospectively (27 cases of PRCC and 13 cases of ChRCC). All patients underwent non-enhanced CT and dual-phase contrast-enhanced CT scans. For each lesion, the CT value of monochromatic images as well as iodine and water concentrations were measured, and the slope of spectrum curve was calculated. Data were analyzed using Student's t-test. Sensitivity and specificity of the quantitative parameters were analyzed using the receiver operating characteristic (ROC) curve.
During the cortex phase (CP) and parenchyma phase (PP), the CT value and slope of spectrum curve of ChRCC were higher than those of PRCC, and significant differences were observed at low energy levels (40-70 keV). Normalized iodine concentration of ChRCC and that of PRCC was significantly different during CP and PP ( < 0.05). The water (iodine) concentrations of ChRCC and PRCC in CP and PP were not statistically different ( > 0.05). All the ROCs for parameters were above the reference line.
Spectral CT may help increase the diagnostic accuracy of differentiating PRCC from ChRCC using a quantitative analysis.
嫌色性肾细胞癌（ChRCC）和乳头状肾细胞癌（PRCC）的计算机断层扫描（CT）图像特征有时难以识别。然而，光谱CT可能提供定量参数以区分它们。
使用光谱CT的定量参数区分ChRCC和PRCC。
回顾性分析40例经病理检查确诊的肾细胞癌病例（27例PRCC和13例ChRCC）。所有患者均接受了非增强CT和双期对比增强CT扫描。对于每个病变，测量单色图像的CT值以及碘和水的浓度，并计算光谱曲线的斜率。使用学生t检验分析数据。使用受试者工作特征（ROC）曲线分析定量参数的敏感性和特异性。
在皮质期（CP）和实质期（PP），ChRCC的CT值和光谱曲线斜率高于PRCC，在低能量水平（40-70 keV）观察到显著差异。ChRCC和PRCC的归一化碘浓度在CP和PP期间有显著差异（<0.05）。ChRCC和PRCC在CP和PP中的水（碘）浓度无统计学差异（>0.05）。所有参数的ROC均高于参考线。
光谱CT可能有助于通过定量分析提高区分PRCC和ChRCC的诊断准确性。
