title: Diagnostic potential of multidetector computed tomography for characterizing small renal masses.
abstract: OBJECTIVE
  To assess the potential of CT for characterizing small renal tumors.
  
  
  METHODS
  76 patients with <4 cm renal tumors underwent CT examination. The following parameters were assessed: presence of calcifications, densitometry on unenhanced and enhanced scans, washout percentage, urinary tract infiltration, star-shaped scar, and paradoxical effect.
  
  
  RESULTS
  Calcifications were found in 7/56 (12.5%) carcinomas. Clear cell carcinomas were as follows: mean density 183.5 HU (arterial phase), 136 HU (portal phase), and 94 HU (delayed phase), washout 34.3%; chromophobe carcinomas were as follows: mean density 135 HU (arterial phase), 161 HU (portal phase), and 148 HU (delayed phase), washout 28%; papillary carcinomas were as follows: mean density 50.3 HU (arterial phase), 60 HU (portal phase), and 58.1 HU (delayed phase), washout 2.7%. In 2/56 (3.6%) cases urinary tract infiltration was found. Oncocytomas were as follows: mean density 126.5 HU (arterial phase), 147.5 HU (portal phase), and 115.5 HU (delayed phase), washout 28.6%. On unenhanced scans, angiomyolipomas were as follows: density values <30 HU in 12/12 (100%) of cases and on enhanced scans: mean density 78 HU (arterial phase), 128 HU (portal phase), and 80 HU (delayed phase), washout 50%.
  
  
  CONCLUSIONS
  Intralesional calcifications and urinary tract infiltration are suggestive for malignancy, with the evidence of adipose tissue for angiomyolipomas and a modest increase in density with a reduced washout for papillary carcinomas. The intralesional density on enhanced scans, peak enhancement, and washout do not seem significant for differentiating clear cell, chromophobe carcinomas, angiomyolipomas, and oncocytomas.
authors.affiliation: Interdisciplinary Department of Medicine (DIM), Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy.
authors.forename: Maria Elisabetta
authors.initials: ME
authors.lastname: Mancini
authors.affiliation: Interdisciplinary Department of Medicine (DIM), Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Albergo
authors.affiliation: Interdisciplinary Department of Medicine (DIM), Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Moschetta
authors.affiliation: SSFO, U.O. Hospital Pharmacy, University Hospital Policlinico of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy.
authors.forename: Mariacristina
authors.initials: M
authors.lastname: Angelelli
authors.affiliation: Interdisciplinary Department of Medicine (DIM), Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy.
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Scardapane
authors.affiliation: Interdisciplinary Department of Medicine (DIM), Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Angelelli
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D011856:Radiographic Image Enhancement; D047368:Tumor Burden
chemical_list: D003287:Contrast Media