Quantitative evaluation of contrast-enhanced ultrasound for differentiation of renal cell carcinoma subtypes and angiomyolipoma

Cui-Xian Li; Qing Lu; Bei-Jian Huang; Li-Yun Xue; Li-Xia Yan; Feng-Yang Zheng; Jie-Xian Wen; Wen-Ping Wang

doi:10.1016/j.ejrad.2016.01.009

Quantitative evaluation of contrast-enhanced ultrasound for differentiation of renal cell carcinoma subtypes and angiomyolipoma

Eur J Radiol. 2016 Apr;85(4):795-802. doi: 10.1016/j.ejrad.2016.01.009. Epub 2016 Jan 21.

Authors

Cui-Xian Li¹, Qing Lu¹, Bei-Jian Huang², Li-Yun Xue³, Li-Xia Yan³, Feng-Yang Zheng³, Jie-Xian Wen³, Wen-Ping Wang¹

Affiliations

¹ Department of Ultrasound, Zhongshan Hospital of Fudan University, No. 180 of Fenglin Road, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Fudan University, No. 180 of Fenglin Road, Shanghai 200032, China; Ultrasonic Medicine and Engineering Research Institute of Fudan University, No. 180 of Fenglin Road, Shanghai 200032, China.
² Department of Ultrasound, Zhongshan Hospital of Fudan University, No. 180 of Fenglin Road, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Fudan University, No. 180 of Fenglin Road, Shanghai 200032, China; Ultrasonic Medicine and Engineering Research Institute of Fudan University, No. 180 of Fenglin Road, Shanghai 200032, China. Electronic address: huang.beijian@zs-hospital.sh.cn.
³ Department of Ultrasound, Zhongshan Hospital of Fudan University, No. 180 of Fenglin Road, Xuhui District, Shanghai 200032, China; Shanghai Institute of Medical Imaging, Fudan University, No. 180 of Fenglin Road, Shanghai 200032, China.

PMID: 26971426
DOI: 10.1016/j.ejrad.2016.01.009

Abstract

Purpose: To investigate the value of quantitative parameters of contrast-enhanced ultrasound (CEUS) in the differentiation of subtypes of renal cell carcinoma (RCC) and angiomyolipoma (AML).

Methods: The quantitative characteristics of 341 RCCs and 88 AMLs were analyzed with quantitative software (SonoLiver). Quantitative analysis was conducted in the whole tumor (ROItumor) and the maximum enhanced area of the tumor (ROImax), acquiring the parameters of maximum intensity (IMAX), rise time (RT), time to peak (TTP), mean transit time (mTT), and area under the curve (AUC), were derived and analyzed. The difference values between ROImax and normal renal cortex (ΔPar.s, including ΔIMAX, ΔRT, ΔTTP, ΔmTT, ΔAUC) were compared among renal histotypes.

Results: All time-related parameters (including RT, TTP and mTT) of ROImax were shorter than the corresponding parameters of ROItumor in RCC subtypes (all p<0.05), but made no statistical difference in AMLs (all p>0.05). There were significant differences of all ΔPar.s among RCC subtypes and AML (all p<0.01). ΔIMAX and ΔAUC showed the trend that ccRCC>AML>pRCC=chRCC. ΔTTP showed AML=pRCC=chRCC>ccRCC, ΔRT and ΔmTT showed AML>pRCC=chRCC=ccRCC. ΔmTT could distinguish RCC from AML with the area under the ROC curve (AUC) of 0.86. The AUC of ΔIMAX and ΔAUC was 0.89 and 0.92 vs 0.85 and 0.85 for discriminating between pRCC (or chRCC) and AML vs ccRCC and AML.

Conclusions: Quantitative analysis of CEUS is a useful modality in AML and RCC subtypes' differentiation, by using ΔmTT, ΔIMAX and ΔAUC.

Keywords: Angiomyolipoma; Contrast-enhanced ultrasound; Quantitative analysis; Renal cell carcinoma; Subtype.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Angiomyolipoma / diagnostic imaging*
Area Under Curve
Carcinoma, Renal Cell / classification
Carcinoma, Renal Cell / diagnostic imaging*
Contrast Media*
Diagnosis, Differential
Female
Humans
Image Enhancement / methods
Image Processing, Computer-Assisted / methods
Kidney Cortex / diagnostic imaging
Kidney Neoplasms / diagnostic imaging*
Male
Middle Aged
Retrospective Studies
Sensitivity and Specificity
Time Factors

Substances

Contrast Media