Department of Radiology, 74713Lanzhou University Second Hospital, Second Clinical School, Lanzhou University, Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, Gansu, PR China.
Acta Radiol. 2022 Apr;63(4):545-552. doi: 10.1177/02841851211002830. Epub 2021 Mar 28.
Energy spectrum computed tomography (CT) has become a promising approach for the differential diagnosis of tumor subtypes.
To explore the value of energy spectrum CT parameters in the differential diagnosis of high-grade clear cell renal cell carcinoma (ccRCC) and type II papillary renal cell carcinoma (pRCC).
Forty-two cases of high-grade ccRCC and 28 cases of type II pRCC were retrospectively reviewed. All region of interest (ROI) measurements were maintained consistently between the two-phase contrast-enhanced examinations. The ROIs encompassed as much of the enhancing areas of the lesions as possible. Energy spectrum CT parameters of all cases, including the 70 keV (HU) value, normalized iodine concentration (NIC), and energy spectrum curve slope were recorded by two radiologists with over 10 years of experience in abdominal CT diagnosis.
In the cortical phase (CP) and parenchymal phase (PP), the 70 keV (HU) value, NIC, and slope value of the energy spectrum curve of high-grade ccRCC were significantly higher than those of type II pRCC. In the CP, NIC showed the highest differential diagnosis efficiency for the two group tumors, with a sensitivity of 78.9% and a specificity of 77.0%. There was no statistical difference in tumor hemorrhage, tumor envelope, tumor morphology, tumor border, lymph node metastasis, embolism, renal pelvis invasion, or tumor calcification between the two tumor types. However, there was significant difference in the number of tumors ( = 0.019).
Energy spectrum CT parameters are valuable for the differential diagnosis of high-grade ccRCC and type II pRCC.
能谱 CT 已成为肿瘤亚型鉴别诊断的一种有前途的方法。
探讨能谱 CT 参数在鉴别诊断高级别透明细胞肾细胞癌（ccRCC）和 II 型乳头状肾细胞癌（pRCC）中的价值。
回顾性分析 42 例高级别 ccRCC 和 28 例 II 型 pRCC 患者。两次增强检查的 ROI 测量均保持一致。ROI 尽可能包括病变的强化区域。由两位具有 10 年以上腹部 CT 诊断经验的放射科医生记录所有病例的能谱 CT 参数，包括 70keV（HU）值、标准化碘浓度（NIC）和能谱曲线斜率。
在皮质期（CP）和实质期（PP），高级别 ccRCC 的 70keV（HU）值、NIC 和能谱曲线斜率均明显高于 II 型 pRCC。在 CP 中，NIC 对两组肿瘤的鉴别诊断效率最高，其灵敏度为 78.9%，特异度为 77.0%。两种肿瘤类型在肿瘤出血、肿瘤包膜、肿瘤形态、肿瘤边界、淋巴结转移、栓塞、肾盂侵犯或肿瘤钙化方面无统计学差异。然而，肿瘤数量存在显著差异（=0.019）。
能谱 CT 参数对高级别 ccRCC 和 II 型 pRCC 的鉴别诊断具有重要价值。
