title: CT perfusion in the characterisation of renal lesions: an added value to multiphasic CT.
abstract: OBJECTIVE
  To prospectively evaluate if computed tomography perfusion (CTp) could be a useful tool in addition to multiphasic CT in renal lesion characterisation.
  
  
  METHODS
  Fifty-eight patients that were scheduled for surgical resection of a renal mass with a suspicion of renal cell carcinoma (RCC) were enrolled. Forty-one out of 58 patients underwent total or partial nephrectomy after CTp examination, and a pathological analysis was obtained for a total of 49 renal lesions. Perfusion parameters and attenuation values at multiphasic CT for both lesion and normal cortex were analysed. All the results were compared with the histological data obtained following surgery.
  
  
  RESULTS
  PS and MTT values were significantly lower in malignant lesions than in the normal cortex (P < 0.001 and P = 0.011, resp.); PS, MTT, and BF values were also statistically different between oncocytomas and malignant lesions. According to ROC analysis, the accuracy, sensitivity, and specificity to predict RCC were 95.92%, 100%, and 66.7%, respectively, for CTp whereas they were 89.80%, 93.35%, and 50%, respectively, for multiphasic CT.
  
  
  CONCLUSIONS
  A significant difference between renal cortex and tumour CTp parameter values may suggest a malignant renal lesion. CTp could represent an added value to multiphasic CT in differentiating renal cells carcinoma from oncocytoma.
authors.affiliation: Department of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Viale Bracci 10, 53100 Siena, Italy.
authors.forename: Francesco Giuseppe
authors.identifier: 0000-0003-2145-7133
authors.initials: FG
authors.lastname: Mazzei
authors.affiliation: Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Viale Bracci 10, 53100 Siena, Italy.
authors.forename: Maria Antonietta
authors.identifier: 0000-0003-3670-7027
authors.initials: MA
authors.lastname: Mazzei
authors.affiliation: Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Viale Bracci 10, 53100 Siena, Italy.
authors.forename: Nevada
authors.identifier: 0000-0003-4004-5011
authors.initials: N
authors.lastname: Cioffi Squitieri
authors.affiliation: Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Viale Bracci 10, 53100 Siena, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Pozzessere
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy.
authors.forename: Lorenzo
authors.identifier: 0000-0001-9915-1332
authors.initials: L
authors.lastname: Righi
authors.affiliation: Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Viale Bracci 10, 53100 Siena, Italy.
authors.forename: Alfredo
authors.identifier: 0000-0001-9712-9078
authors.initials: A
authors.lastname: Cirigliano
authors.affiliation: Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Viale Bracci 10, 53100 Siena, Italy.
authors.forename: Susanna
authors.identifier: 0000-0001-7875-3342
authors.initials: S
authors.lastname: Guerrini
authors.affiliation: Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Viale Bracci 10, 53100 Siena, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: D'Elia
authors.affiliation: Department of Medical Biotechnologies, Section of Pathology, University of Siena, Viale Bracci 10, 53100 Siena, Italy.
authors.forename: Maria Raffaella
authors.initials: MR
authors.lastname: Ambrosio
authors.affiliation: Department of Medical Biotechnologies, Section of Pathology, University of Siena, Viale Bracci 10, 53100 Siena, Italy.
authors.forename: Aurora
authors.initials: A
authors.lastname: Barone
authors.affiliation: Department of Medical, Surgical and Neuro Sciences, Section of Pathology, University of Siena, Viale Bracci 10, 53100 Siena, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: del Vecchio
authors.affiliation: Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Viale Bracci 10, 53100 Siena, Italy.
authors.forename: Luca
authors.identifier: 0000-0002-6655-5979
authors.initials: L
authors.lastname: Volterrani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009098:Multiphasic Screening; D009392:Nephrectomy; D014057:Tomography, X-Ray Computed