title: Renal cyst pseudoenhancement at multidetector CT: what are the effects of number of detectors and peak tube voltage?
abstract: OBJECTIVE
  To determine the effect of the number of detectors and peak tube voltage on renal cyst pseudoenhancement in a phantom model.
  
  
  METHODS
  This study on computed tomographic (CT) phantoms did not require institutional review board approval. The renal compartments of a CT phantom were filled with iodinated contrast material diluted to attain attenuations of 40, 140, and 240 HU. Saline-filled cylinders simulating cysts of varying diameters (range, 0.7-3.0 cm) were serially suspended in the renal compartments and scanned at 80, 90, 100, 120, and 140 kVp in 16-detector (n = 3) and 64-detector (n = 2) CT scanners. Generalized estimating equations were used to determine predictors of cyst pseudoenhancement (defined as a >10 HU increase in cyst attenuation when the background renal attenuation increased from 40 to 140 or 240 HU).
  
  
  RESULTS
  Pseudoenhancement was seen with higher frequency (59 [61%] of 96 cysts vs 52 [39%] of 132 cysts, P < .05) and magnitude (17 vs 13 HU, P < .005) with 64- rather than with 16-detector scanners. Pseudoenhancement was also seen with higher frequency (25 [42%] of 60 cysts vs 11 [18%] of 60 cysts, P < .005) and magnitude (18 vs 13 HU, P < .05) at 140 kVp than at 80 or 90 kVp. Cyst pseudoenhancement increased with higher background renal enhancement (P < .005) and smaller cyst diameter (P < .05). The number of detectors, peak tube voltage, renal parenchymal enhancement level, and cyst diameter were independent predictors of cyst pseudoenhancement.
  
  
  CONCLUSIONS
  Lower tube voltage settings may be useful when accurate differentiation between small renal cysts and solid masses is critical, particularly for 64-detector CT scanners.
authors.affiliation: Department of Radiology, University of California-San Francisco, 505 Parnassus Ave, Box 0628, C-372C, San Francisco, CA 94143-0628, USA. jane.wang@radiology.ucsf.edu
authors.forename: Zhen J
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Fergus V
authors.initials: FV
authors.lastname: Coakley
authors.forename: Yanjun
authors.initials: Y
authors.lastname: Fu
authors.forename: Bonnie N
authors.initials: BN
authors.lastname: Joe
authors.forename: Sven
authors.initials: S
authors.lastname: Prevrhal
authors.forename: Luis A
authors.initials: LA
authors.lastname: Landeras
authors.forename: Emma M
authors.initials: EM
authors.lastname: Webb
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Yeh
mesh_terms: D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D052177:Kidney Diseases, Cystic / Q000000981:diagnostic imaging*; D019047:Phantoms, Imaging; D011856:Radiographic Image Enhancement / Q000295:instrumentation* / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods*