caa a22 4500 605492522 CHVBK 20210128100515.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s00261-014-0340-5 doi (NATIONALLICENCE)springer-10.1007/s00261-014-0340-5 Histotype differentiation of hypo-echoic renal tumors on CEUS: usefulness of enhancement homogeneity and intensity [Elektronische Daten] [Qing Lu, Li-yun Xue, Bei-jian Huang, Wen-ping Wang, Cui-xian Li] Purpose: The purpose of this study is to evaluate qualitative and quantitative analysis of contrast-enhanced ultrasound (CEUS) in differential diagnoses of hypo-echoic renal tumor histotypes. Methods: Our study cohort comprised 103 clear cell renal cell carcinomas (ccRCCs), 24 papillary renal cell carcinomas (pRCCs), 28 chromophobe renal cell carcinomas (cRCCs), and 34 angiomyolipomas (AMLs), hypo-echoic on ultrasound, and imaged between January 2011 and December 2013. Enhancement homogeneity and tumor-to-cortex intensity ratio (TOC ratio) were retrospectively analyzed. Results: Overall, heterogeneous enhancement was more common in ccRCCs than AMLs, pRCCs, and cRCCs. TOC ratio showed the trend ccRCC>AML>pRCC=cRCC. Similar trends were seen in tumors <4cm. Using heterogeneous enhancement or TOC ratio >107.5% to differentiate ccRCC from other histotypes, the sensitivity, specificity, positive and negative predictive values were 93.1%, 74.5%, 84.8%, and 87.5%, respectively. Tumors >4cm exhibited considerable overlap in enhancement homogeneity among different histotypes. TOC ratios were similar between homo- and heterogeneously enhancing tumors for ccRCCs and for pRCCs and cRCCs, but higher in homogeneously enhancing than heterogeneously enhancing AMLs. In homo- and heterogeneously enhancing tumors, TOC ratios followed the trends ccRCCs>AMLs>pRCCs=cRCCs and ccRCCs>AMLs=pRCCs=cRCCs, respectively. With TOC ratio >105.81% and >72.37% to differentiate homo- and heterogeneously enhancing ccRCCs from other histotypes in tumors >4cm with same enhancement homogeneity, the sensitivity, specificity, positive and negative predictive values were 70.0%, 85.7%, 70.0%, 85.7%, and 91.7%, 94.4%, 95.7%, 89.5%, respectively. Conclusion: CEUS homogeneity and TOC ratio are helpful in differential diagnosis of hypo-echoic renal tumor histotypes. Diameter and enhancement homogeneity should be considered when deciding the diagnostic TOC ratio cutoff. Springer Science+Business Media New York, 2014 Histotype nationallicence Renal tumor nationallicence Contrast-enhanced ultrasound nationallicence Quantitative analysis nationallicence Lu Qing Department of Ultrasound, Shanghai Medical Imaging Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, 200032, Shanghai, China aut Xue Li-yun Department of Ultrasound, Shanghai Medical Imaging Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, 200032, Shanghai, China aut Huang Bei-jian Department of Ultrasound, Shanghai Medical Imaging Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, 200032, Shanghai, China aut Wang Wen-ping Department of Ultrasound, Shanghai Medical Imaging Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, 200032, Shanghai, China aut Li Cui-xian Department of Ultrasound, Shanghai Medical Imaging Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, 200032, Shanghai, China aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/6(2015-08-01), 1675-1683 0942-8925 40:6<1675 2015 40 261 https://doi.org/10.1007/s00261-014-0340-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-014-0340-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lu Qing Department of Ultrasound, Shanghai Medical Imaging Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, 200032, Shanghai, China aut NATIONALLICENCE 700 1- Xue Li-yun Department of Ultrasound, Shanghai Medical Imaging Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, 200032, Shanghai, China aut NATIONALLICENCE 700 1- Huang Bei-jian Department of Ultrasound, Shanghai Medical Imaging Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, 200032, Shanghai, China aut NATIONALLICENCE 700 1- Wang Wen-ping Department of Ultrasound, Shanghai Medical Imaging Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, 200032, Shanghai, China aut NATIONALLICENCE 700 1- Li Cui-xian Department of Ultrasound, Shanghai Medical Imaging Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, 200032, Shanghai, China aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/6(2015-08-01), 1675-1683 0942-8925 40:6<1675 2015 40 261