title: Distinguishing enhancing from nonenhancing renal masses with dual-source dual-energy CT: iodine quantification versus standard enhancement measurements.
abstract: OBJECTIVE
  To compare the diagnostic accuracy of iodine quantification and standard enhancement measurements in distinguishing enhancing from nonenhancing renal masses.
  
  
  METHODS
  The Institutional Review Board approved this retrospective study conducted from data found in institutional patient databases and archives. Seventy-two renal masses were characterised as enhancing or nonenhancing using standard enhancement measurements (in HU) and iodine quantification (in mg/ml). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of standard enhancement measurements and iodine quantification were calculated from χ (2) tests of contingency with histopathology or imaging follow-up as the reference standard. Difference in accuracy was assessed by means of McNemar analysis.
  
  
  RESULTS
  Sensitivity, specificity, PPV, NPV and diagnostic accuracy for standard enhancement measurements and iodine quantification were 77.7 %, 100 %, 100 %, 81.8 %, 89 % and 100 %, 94.4 %, 94.7, 100 % and 97 %, respectively. The McNemar analysis showed that the accuracy of iodine quantification was significantly better (P < 0.001) than that of standard enhancement measurements.
  
  
  CONCLUSIONS
  Compared with standard enhancement measurements, whole-tumour iodine quantification is more accurate in distinguishing enhancing from nonenhancing renal masses.
  
  
  CONCLUSIONS
  • Enhancement of renal lesions is important when differentiating benign from malignant tumours. • Dual-energy CT offers measurement of iodine uptake rather than mere enhancement values. • Whole-tumour iodine quantification seems more accurate than standard CT enhancement measurements.
authors.affiliation: Department of Radiological Sciences, Policlinico "G. Martino", Messina, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ascenti
authors.forename: Achille
authors.initials: A
authors.lastname: Mileto
authors.forename: Bernhard
authors.initials: B
authors.lastname: Krauss
authors.forename: Michele
authors.initials: M
authors.lastname: Gaeta
authors.forename: Alfredo
authors.initials: A
authors.lastname: Blandino
authors.forename: Emanuele
authors.initials: E
authors.lastname: Scribano
authors.forename: Nicola
authors.initials: N
authors.lastname: Settineri
authors.forename: Silvio
authors.initials: S
authors.lastname: Mazziotti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007455:Iodine; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007455:Iodine