Abstract
BackgroundRenal cell carcinoma (RCC) is the most common renal malignant tumour. We evaluated the potential value and dose reduction of virtual non-contrast (VNC) images and virtual monoenergetic images (VMIs) from dual-layer spectral CT (DL-CT) in the diagnosis of RCC.ResultsSixty-two patients with pathologically confirmed RCC who underwent contrast-enhanced DL-CT were retrospectively analysed. For the comparison between true non-contrast (TNC) and VNC images of the excretory phase, the attenuation, image noise, signal-to-noise ratio (SNR) and subjective image quality of tumours and different abdominal organs and tissues were evaluated. To compare corticomedullary phase images and low keV VMIs (40 to 100 keV) from the nephrographic phase, the attenuation, image noise, SNR and subjective lesion visibility of the tumours and renal arteries were evaluated. For the tumours, significant differences were not observed in attenuation, noise or SNR between TNC and VNC images (p > 0.05). For the abdominal organs and tissues, except for fat, the difference in attenuation was 100% within 15 HU and 96.78% within 10 HU. The subjective image quality of TNC and VNC images was equivalent (p > 0.05). The attenuation of lesions in 40 keV VMIs and renal arteries in 60 keV VMIs were similar to those in the corticomedullary images (p > 0.05). The subjective lesion visibility in low keV VMIs is slightly lower than that in the corticomedullary images (p < 0.05). Using VNC and VMIs instead of TNC and corticomedullary phase images could decrease the radiation dose by 50.5%.ConclusionVNC images and VMIs acquired from DL-CT can maintain good image quality and decrease the radiation dose for diagnosis of RCC.
Highlights
Renal cell carcinoma (RCC) is the most common renal malignant tumour
virtual non-contrast (VNC) images and Virtual monoenergetic image (VMI) acquired from duallayer spectral CT (DL-CT) can maintain good image quality and decrease the radiation dose for diagnosis of RCC
This study evaluated whether low keV VMIs from the nephrographic phase could provide sufficient clinical diagnostic information similar to corticomedullary images in the observation of RCC
Summary
Renal cell carcinoma (RCC) is the most common renal malignant tumour. Most of the malignant tumours found in kidney CT examination are renal cell carcinomas (RCCs), which account for nearly 85% of all renal cancers in adults [1,2,3]. The most common histology of RCC is clear cell renal cell carcinoma (ccRCC), which accounts for 70% to 80% [4]. CT scans have the advantages of short imaging time, few contraindications and high accuracy and are currently the most commonly used examination method for preoperative diagnosis and staging of RCC [5, 6]. For the best diagnosis and most accurate staging, the reference standard for dedicated multiphase renal cell carcinoma imaging consists of unenhanced phase, corticomedullary phase, nephrographic phase and excretory phase scans [7]. Radiation dose remains a concern for patients with RCC
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
