title: Lesion Size and Iodine Quantification to Distinguish Low-Grade From High-Grade Clear Cell Renal Cell Carcinoma Using Dual-Energy Spectral Computed Tomography.
abstract: OBJECTIVE
  The aim of this study was to assess the utility of lesion size and iodine quantification using dual-energy spectral computed tomography to distinguish between low-grade and high-grade clear cell renal cell carcinomas (ccRCCs).
  
  
  METHODS
  Spectral parameters of 75 patients with pathologically proven ccRCCs who underwent preoperative dual-energy spectral computed tomography examinations were divided into low-grade and high-grade groups. Independent sample t test, receiver operating characteristic curve analysis, and Spearman rank correlation were analyzed.
  
  
  RESULTS
  The lesion size was significantly smaller, and spectral parameters were significantly higher in the low-grade ccRCC. The significant correlation (r = -0.412, P < 0.001) by the Spearman rank correlation was between the normalized iodine concentration and lesion size. The receiver operating characteristic analysis demonstrated that 0.710 was the optimal cutoff value, which yielded the following: sensitivity, 97.6%; specificity, 97.1%; positive predictive value, 97.6%; negative predictive value, 97.1%; and accuracy, 97.3%.
  
  
  CONCLUSIONS
  Iodine quantification can play an important role in distinguishing low-grade from high-grade ccRCC.
authors.affiliation: From the Departments of *Radiology, †Urological Oncology, and ‡Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
authors.forename: Jinkun
authors.initials: J
authors.lastname: Zhao
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.forename: Xusheng
authors.initials: X
authors.lastname: Chen
authors.forename: Wenfeng
authors.initials: W
authors.lastname: Cao
authors.forename: Zhaoxiang
authors.initials: Z
authors.lastname: Ye
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology*; D003198:Computer Simulation; D003287:Contrast Media / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007455:Iodine / Q000493:pharmacokinetics*; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D060787:Neoplasm Grading; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D047368:Tumor Burden
chemical_list: D003287:Contrast Media; D007455:Iodine