Dual-energy Ct Clinical Value Of Renal Cell Carcinoma Diagnosis

Dual-energy CT in Patients with Renal Cell Carcinoma:Assessment of Virtual Enhanced ImagesPurpose: To quantatively and quantitatively compare virtual nonenhanced(VNE) data sets derived from dual-energy(DE) computed tomography(CT) with true nonenhanced(TNE) data sets in the same patients and to calculate potential radiation dose reductions for a dual-phase renal multidetector CT compared with a standared triple-phase proctocol.Materials and methods:This prospective study was approved by the institutional review board;all patients provaded written informed consent. Thirty-five person(30 men and 5 women,age range:31-82 years) underwent preoperative DECT that included unenhanced,DE Corticomedullary and Nephrographic phases.DECT parameters were 80 and 140kvp.CT numbers were measured on TNE and VNE images.Exclusion of relevant anatomy with the 26cm field of view detector was quantified with a five-point scale(0=none,4>=75%). Image acceptability for VNE and TNE images wire calvulated.Difference wire tested with a student t test for paired samples.Results:Mean CT numbers (±standard deviation) on TNE and VNE images,respectively,for renal parenchyma;aorta,psoas and tumor were 26.26±8.62和29.59±7.28(P=0.130),57.61±6.36和54.24±10.18(P=0.034),44.33±4.99和40.78±12.19(P=0.197),46.30±10.45和41.91±7.71(P=0.520),29.23±10.45和26.06±15.76(P=0.262),repectively.No exclusion of the contralateral kidney was seen in 26 patients,less than 25% was 6,25-50% was seen in 3 patients,and 50-75 was seen in 0 patients.Mean dose reduction by omitting the TNE scan was 35%.Conclusion:In patients with renal masses,DECT can provide high quality VNE data sets,which are a reasonable approximation of TNE data sets.integration of DE scanning into a renal mass protocol will lower radiation exposure by 35%.Part Two The Diagnostic Value of Multiphase Scanning for Renal Carcinoma and the Differentiation of histologic Subtypes by DECTPurpose:To assess the accuracy of DECT scanning in multiphase protocol. Material and Methods:Retospectively analyze the 35 cases of RCC, which was scanned by DECT during september in 2008 and February in 2010 and prove by pathology, blindly stage the cases and evalutate the presence of pseudocapsule. The results were compared with pathology. Results:The accuracy of stage rate by DECY were stage I 100%, stage II 78%, stageⅢ100%, stage IV 100%, the rate of the presence of pseudocapsule was 80%.Conclusion:DECT multiphase scanning have high accuracy of stage rate, and have advantage of the display of pseudocapsule.Part Three The Display of the Pseudocapsule and the Preoperative Evaluation of RCC by DECTPurpose:To quantatively and quantitatively compare virtual nonenhanced(VNE) data sets derived from dual-energy(DE) computed tomography(CT) with true nonenhanced(TNE) data sets in the same patients and to calculate potential radiation dose reductions for a dual-phase renal multidetector CT compared with a standared triple-phase proctocol.Materials and methods:This prospective study was approved by the institutional review board;all patients provaded written informed consent. Thirty-five person(30 men and 5 women,age range:31-82 years) underwent preoperative DECT that included unenhanced,DE Corticomedullary and Nephrographic phases.DECT parameters were 80 and 140kv.CT numbers were measured on TNE and VNE images.Exclusion of relevant anatomy with the 26cm field of view detector was quantified with a five-point scale(0=none,4>=75%). Image acceptability for VNE and TNE images wire calvulated.Difference wire tested with a student t test for paired samples.Results:Mean CT numbers (±standard deviation) on TNE and VNE images,respectively,for renal parenchyma;aorta,psoas and tumor were 26.26±8.62和29.59±7.28 (P=0.130),57.61±6.36和54.24±10.18(P=0.034),44.33±4.99和40.78±12.19(P=0.197),46.30±10.45和41.91±7.71(P=0.520),29.23±10.45和26.06±15.76(P=0.262),repectively.No exclusion of the contralateral kidney was seen in 26 patients,less than 25% was 6,25-50% was seen in 3 patients,and 50-75 was seen in 0 patients.Mean dose reduction by omitting the TNE scan was 35%.a sets,Conclusion:In patients with renal masses,DECT can provide high quality VNE data sets,which are a reasonable approximation of TNE data sets.integration of DE scanning into a renal mass protocol will lower radiation exposure by 35%.