Renal tumors have various pathologic types. The traditional CT diagnosis of renal tumor is limited to the morphological description of lesion size, morphology, density and so on. For some lesions without typical imaging characteristics, it is difficult for radiologists to make qualitative diagnosis of the lesions. As a new imaging technology, the energy spectrum imaging function carried by the Campo Imaging Precision series CT products can obtain 101 consecutive single energy images of 40keV-140keV, and achieve qualitative separation and quantitative determination of substances to a certain extent through energy spectrum curve and material density analysis. Comprehensive analysis of the energy spectrum characteristics of plain scan and enhanced phase is beneficial to the localization and characterization of renal tumors. Precision 128 CT not only has the characteristics of traditional CT, but also can reflect tumor blood flow through iodinogram and material energy attenuation characteristics through energy spectrum curve, so as to make a more comprehensive evaluation and diagnosis of diseases. In this paper, the energy spectrum characteristics of renal clear cell carcinoma, the most common malignant tumor of kidney, and renal hamartoma, the most common benign tumor of kidney, were analyzed by using Precision 128 CT. It is proved that Precision 128 CT has high sensitivity and specificity in the clinical diagnosis of renal clear cell carcinoma and adipose renal hamartoma, which has great application and promotion value in clinic.
——Wen Jing, senior clinical expert of Campo Imaging Medical
Differential diagnosis of renal clear cell carcinoma and adipose renal hamartoma by Precision 128 CT in clinical trials
Wen Lijuan, WANG Li, Daytime, Zhang Na, Sun Xuejia, Zuo Mingfei
The Third Affiliated Hospital Of Qiqihar Medical University
Objective: To study and analyze the value of Precision 128 CT in differential diagnosis of renal clear cell carcinoma and adipose renal hamartoma in clinical trials. Method: The study is conducted from June 2019 to June 2020. Sixty patients in the abdominal group who were suspected of renal cell carcinoma or renal hamartoma were selected from the Precision 128 CT clinical trial conducted by our hospital and three hospitals cooperating with Campo Imaging. All patients received Precision 128 CT plain and dual-phase enhanced CT, and the examination results were compared with the surgical pathological results. Result: Sixty patients suspected of renal cell carcinoma or renal hamartoma were confirmed by surgical pathology, 28 patients were renal clear cell carcinoma and 16 patients were adipose renal hamartoma. The sensitivity and specificity of Precision 128 CT for the diagnosis of renal clear cell carcinoma were 85.9% and 81.8% respectively. The sensitivity and specificity were 82.6% and 85.9% for the diagnosis of adipose renal hamartoma. Conclusion: Precision 128 energy spectrum CT has high sensitivity and specificity in the clinical diagnosis of renal clear cell carcinoma and adipose renal hamartoma, which has great value in clinical application and promotion.
Renal clear cell carcinoma is the most common subtype of primary renal malignant tumor cell carcinoma, and its incidence is increasing year by year. Renal hamartoma is the most common benign tumor of kidney. It is difficult to distinguish adipose renal hamartoma from renal clear cell carcinoma, especially when conventional CT is single-parameter and mixed energy imaging [1]. This study was conducted from June 2019 to June 2020. Sixty patients suspected of renal cell carcinoma or renal hamartoma were selected from the clinical trial during this period to analyze the features of conventional imaging with energy spectrum of renal clear cell carcinoma and adipose renal hamartoma. To study the application value of energy spectrum imaging and analysis in the differential diagnosis of renal clear cell carcinoma and adipose renal hamartoma.
In clinical work, radiologists can correctly recognize and diagnose renal clear cell carcinoma with typical enhanced mode of "quick in, quick out" on CT, but it is difficult to accurately identify and diagnose a small part of renal clear cell carcinoma, papillary renal carcinoma, chromophobe cell carcinoma and other renal carcinoma with poor blood supply. In particular, it is easy to be confused with some renal angiomyolipomas (hamartomas) with poor fat composition and lack of representation. Therefore, the correct preoperative diagnosis of both is particularly important. Renal hamartoma is an uncommon benign tumor, accounting for about 1.3% of all renal tumors, among which adipose renal hamartoma accounts for about 20.0%. Due to the abundant internal blood vessels of adipose renal hamartoma , the vessels are severely tortuous, which is prone to spontaneous or post-traumatic rupture bleeding, seriously threatening the lives of patients. Therefore, it is of great clinical significance to make early accurate diagnosis and timely and accurate treatment. Energy spectrum is a new design, with a series of technical innovations of high-definition energy spectrum, the use of new detector materials, with high purity and high permeability of physical characteristics, increasing the image chain sampling rate, as well as algorithm innovation, so that energy spectrum under the condition of lower dose, can obtain clearer image quality. The spatial resolution and density resolution have reached the highest so far. In this study, the newly developed Precision 128 CT of Precision tomography has made significant breakthroughs compared with traditional methods in removing beam hardening artifacts, optimizing image quality and comparing contrast to noise ratio, quantitative analysis of materials and comprehensive analysis of energy spectrum. It has the characteristics of low-dose imaging, improving the detection rate of small lesions and multiple lesions, improving the accuracy of tumor localization and qualitative analysis, stone detection and component analysis, providing a reliable basis for early diagnosis, accurate diagnosis, qualitative and quantitative evaluation of lesions. According to the results of this study, the sensitivity and specificity of Precision 128 CT for the diagnosis of renal clear cell carcinoma were 85.9% and 81.8%, respectively. The sensitivity and specificity were 82.6% and 85.9% for the diagnosis of adipose renal hamartoma. It shows its high sensitivity and specificity in the diagnosis of two kinds of tumors and its clinical value.
In conclusion, Precision 128 CT has high diagnostic sensitivity and specificity in the clinical diagnosis of renal clear cell carcinoma and adipose renal hamartoma, which is of great value in clinical application and promotion.