Usefulness of MDCT to differentiate between renal cell carcinoma and oncocytoma: Development of a predictive model

Blanca Paño*, Napoleon Macías, Rafael Salvador, Ferran Torres, Laura Buñesch, Carmen Sebastià, Carlos Nicolau

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

9 Citations (Scopus)

Abstract

OBJECTIVE: The objective of our study was to identify the most useful parameters to differentiate between renal cell carcinoma (RCC) and oncocytoma using four-phase CT. MATERIALS AND METHODS: Ninety-seven patients with solid renal lesions who underwent surgery with four-phase preoperative CT evaluation and with pathologic diagnosis of RCC or oncocytoma were included in the study. Features of tumors and the enhancement pattern in the four CT phases were evaluated and analyzed. Logistic regression models were used to assess independent predictors for malignancy. RESULTS: Histopathologically, 13 tumors were oncocytomas and 84 were RCCs. RCCs were larger (6.20 cm vs 3.21 cm, p = 0.0004) and more often enhanced heterogeneously (66 vs 6, p = 0.02). Lesions that were larger than 4 cm showed a significantly higher risk of malignancy (p = 0.0046). Significant differences were found in intensity of nodule enhancement between the nephrographic and the excretory phases with respect to the unenhanced phase (p = 0.003 and p = 0.0026). At multivariate analysis, parameters that were independent predictors of malignancy were enhancement pattern, with RCCs more often having heterogeneous enhancement than oncocytomas (odds ratio [OR], 0.18; 95% CI, 0.04-0.90), and nodule enhancement in the excretory phase in relation to the unenhanced phase, with RCCs showing lower enhancement (OR, 0.93; 95% CI, 0.88-0.97), and a size larger than 4 cm (OR, 4.01; 95% CI, 0.70-23.14). CONCLUSION: The combination of different CT parameters including lesion size larger than 4 cm, lesion enhancement in the excretory phase in relation to the unenhanced phase, and heterogeneous enhancement pattern helps distinguish RCC from oncocytoma.

Original languageAmerican English
Pages (from-to)764-774
Number of pages11
JournalAmerican Journal of Roentgenology
Volume206
Issue number4
DOIs
Publication statusPublished - Apr 2016

Keywords

  • Mdct
  • Oncocytoma
  • Renal cell carcinoma

Fingerprint Dive into the research topics of 'Usefulness of MDCT to differentiate between renal cell carcinoma and oncocytoma: Development of a predictive model'. Together they form a unique fingerprint.

Cite this