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Iodine quantification to distinguish clear cell from papillary renal cell carcinoma at dual-energy multidetector CT: a multireader diagnostic performance study.

Publication ,  Journal Article
Mileto, A; Marin, D; Alfaro-Cordoba, M; Ramirez-Giraldo, JC; Eusemann, CD; Scribano, E; Blandino, A; Mazziotti, S; Ascenti, G
Published in: Radiology
December 2014

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 AND METHODS: 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.

Duke Scholars

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

December 2014

Volume

273

Issue

3

Start / End Page

813 / 820

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Nuclear Medicine & Medical Imaging
  • Nephrectomy
  • Multidetector Computed Tomography
  • Middle Aged
  • Male
  • Kidney Neoplasms
  • Iopamidol
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mileto, A., Marin, D., Alfaro-Cordoba, M., Ramirez-Giraldo, J. C., Eusemann, C. D., Scribano, E., … Ascenti, G. (2014). Iodine quantification to distinguish clear cell from papillary renal cell carcinoma at dual-energy multidetector CT: a multireader diagnostic performance study. Radiology, 273(3), 813–820. https://doi.org/10.1148/radiol.14140171
Mileto, Achille, Daniele Marin, Marcela Alfaro-Cordoba, Juan Carlos Ramirez-Giraldo, Christian D. Eusemann, Emanuele Scribano, Alfredo Blandino, Silvio Mazziotti, and Giorgio Ascenti. “Iodine quantification to distinguish clear cell from papillary renal cell carcinoma at dual-energy multidetector CT: a multireader diagnostic performance study.Radiology 273, no. 3 (December 2014): 813–20. https://doi.org/10.1148/radiol.14140171.
Mileto A, Marin D, Alfaro-Cordoba M, Ramirez-Giraldo JC, Eusemann CD, Scribano E, et al. Iodine quantification to distinguish clear cell from papillary renal cell carcinoma at dual-energy multidetector CT: a multireader diagnostic performance study. Radiology. 2014 Dec;273(3):813–20.
Mileto, Achille, et al. “Iodine quantification to distinguish clear cell from papillary renal cell carcinoma at dual-energy multidetector CT: a multireader diagnostic performance study.Radiology, vol. 273, no. 3, Dec. 2014, pp. 813–20. Pubmed, doi:10.1148/radiol.14140171.
Mileto A, Marin D, Alfaro-Cordoba M, Ramirez-Giraldo JC, Eusemann CD, Scribano E, Blandino A, Mazziotti S, Ascenti G. Iodine quantification to distinguish clear cell from papillary renal cell carcinoma at dual-energy multidetector CT: a multireader diagnostic performance study. Radiology. 2014 Dec;273(3):813–820.

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

December 2014

Volume

273

Issue

3

Start / End Page

813 / 820

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Nuclear Medicine & Medical Imaging
  • Nephrectomy
  • Multidetector Computed Tomography
  • Middle Aged
  • Male
  • Kidney Neoplasms
  • Iopamidol
  • Humans
  • Female