Chao Chen, Presenter: Nothing to Disclose

Jianping Lu MD, Abstract Co-Author: Nothing to Disclose

Bing Xu, Abstract Co-Author: Nothing to Disclose

Qi Liu MD, PhD, Abstract Co-Author: Nothing to Disclose

 To compare various CT perfusion features of angiomyolipoma (AML) with minimal fat with those of size-matched renal cell carcinoma (RCC).

Twelve patients (12 with AML with minimal fat [mean diameter, 3.0 cm; range, 1.8–4.3 cm] and 58 with RCC [mean diameter, 3.1 cm; range, 2.0–4.3 cm]) who had undergone 320-slice dynamic volume CT perfusion were evaluated. The age and sex distribution were compared between the AML with minimal fat and the RCC. Equivalent blood volume (Equiv BV), permeability surface-area product (PS), and blood flow (BF) of tumor and normal renal cortex were measured and analyzed. Receiver operating characteristic (ROC) curve analysis was performed for the comparison of AML with minimal fat and RCC.

The mean Equiv BV of normal renal cortex, AML with minimal fat, and RCC were (112.9±16.7) ml/100mg, (48.2±6.4) ml/100mg, and (77.8±20.2) ml/100mg, respectively. The mean PS of normal renal cortex, AML with minimal fat, and RCC were (207.9±68.7) ml/100mg/min, (98.2±16.4) ml/100mg/min and (90.8±26.2) ml/100mg/min, respectively. The mean BF of normal renal cortex, AML with minimal fat, and RCC were (296.9±18.7) ml/100mg/min, (138.2±86.4) ml/100mg/min, and (213.8±26.2) ml/100mg/min, respectively. There was a significant difference in all three parameters between tumor and normal renal cortex (P<0.001). Equiv BV and BF were significantly different between AML with minimal fat and RCC (P<0.05). Equiv BV and BF were highly predictive for distinguishing between AML with minimal fat and RCC, with areas under the ROC curves of 0.80 and 0.96. A threshold value of 56.16 ml/100mg in Equiv BV permitted this distinction with 79% sensitivity, 86% specificity, and 80% accuracy. A threshold value of 153.84 ml/100mg/min in BF permitted this distinction with 79% sensitivity, 98% specificity, and 95% accuracy.  

Perfusion imaging using 320-slice dynamic volume CT may be useful in differentiating AML with minimal fat from RCC, with Equiv BV and BF being valuable perfusion parameters.

CT perfusion imaging can demonstrate the perfusion features of angiomyolipoma (AML) with minimal fat with those of size-matched renal cell carcinoma (RCC) and is useful  in the differential diagnosis of these two types of tumors.

Chen, C, Lu, J, Xu, B, Liu, Q, Angiomyolipoma with Minimal Fat: Differentiation from Renal Cell Carcinoma at 320-slice Dynamic Volume CT Perfusion.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010423.html