Journal of Korean Society of Ultrasound in Medicine 2010;29(2): 105-113.
Ultrasonographic Differentiation of Small Angiomyolipoma from Renal Cell Carcinoma by Measuring Relative Echogenicity on PACS.
Myoung Seok Lee, Jeong Yeon Cho, Seung Hyup Kim
1Department of Radiology, Seoul National University Hospital, Korea. radjycho@radiol.snu.ac.kr
2Institute of Radiation Medicine, Seoul National University Medical Research Center, Korea.
3Kidney Research Institute, Seoul National University Medical Research Center, Korea.
  Published online: June 1, 2010.
ABSTRACT
PURPOSE: To retrospectively evaluate the diagnostic value of ultrasonographic differentiation of small angiomyolipomas (AMLs) from renal cell carcinomas (RCCs) by measuring relative echogenicity (RE) on PACS. MATERIALS AND METHODS: Thirty-six cases of < 3 cm, pathologically-proven RCCs and 42 cases of size-matched AMLs were enrolled. We measured the grayscale representing echogenicity of the mass, the renal cortex, and the sinus fat on PACS using a ROI cursor. The RE of the tumor was calculated by setting the grayscale of the renal cortex and sinus fat as 0% and 100%, respectively. We compared REs of AMLs and RCCs, including subgroups of each tumor. ROC analyses between RCCs and AMLs or non-fatty AMLs were performed for obtaining diagnostic performance (Az value) of RE measurement and for extracting sensitivities of RE with fixed specificities of 90% and 95%. RESULTS: The RE of AMLs was higher than RCCs (p < 0.05). The RE of non-fatty AMLs was significantly lower than fatty AMLs, and higher than any subgroups of RCCs (p < 0.05). RE measurement provided good diagnostic performance (Az > or = 0.840, p < 0.05) with competitive sensitivity/specificity for differentiating AMLs from RCCs regardless of AML subgroups. CONCLUSIONS: RE measurement on PACS can be helpful in the differential diagnosis of small AMLs and RCCs with the intrinsic merits of ultrasonography.
Keywords: Kidney; Angiomyolipoma; Renal cell carcinoma; PACS; Ultrasound
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