Automated iodine maps on PCCT showed strong diagnostic performance to differentiate renal cysts from neoplasms, with AUC up to 0.99.
Renal cysts consistently demonstrated near-zero iodine concentration, while neoplasms showed higher and more heterogeneous iodine values.
Minimum iodine concentration in suspicious regions was particularly powerful, nearly perfectly separating benign vs malignant lesions.
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Figure 2. (a) A 86-year-old female who presented with abdominal pain. Reconstructed iodine quantification map of the axial CT image shows the left kidney with renal cyst. For homogeneous lesions, one ROI was placed in the interior of the renal lesion, as large as possible to cover the entire lesion (yellow arrow pointing to the ROI shown as yellow circle). (b) A 64-year-old female presented for RCC staging. A reconstructed iodine quantification map of the axial CT image shows the right kidney with renal neoplasm. For heterogeneous lesions, after the placement of the first ROI (yellow arrow pointing to the ROI shown as yellow circle), a secondary ROI (yellow star marking the ROI shown as yellow circle) was placed on the area of the highest conspicuity of iodine concentration. (CT: Computed tomography, RCC: Renal cell carcinoma, ROI: Region of interest).
Source: Tóth et al., Journal of Clinical Imaging Science, 2024
Protocol
Detail | Value |
|---|
Scanner | NAEOTOM Alpha |
Scan area | Abdomen |
Scan mode | QuantumPlus |
Tube voltage [kV] | 120 |
Effective mAs [mAs] | 184.9 ± 77.3 |
IQ level | 249 |
Dose modulation | CARE Dose4D |
CTDIvol [mGy] | 15.2 ± 6.6 |
DLP [mGy*cm] | 1020.5 ± 608.0 |
Rotation time [s] | 0.5 |
Pitch | 0.8 |
Matrix | 512 × 512 |
Slice collimation [mm] | 144 × 3 |
Slice width [mm] | 3 |
keV level [keV] | n.a. |
Contrast agent | Omnipaque 350 mgI/mL |
Contrast volume | 1.25 ± 0.13 mL/kg |
Flow rate | 2.96 ± 0.59 mL/s |
Tóth A, Chamberlin JH, Mendez S, Varga-Szemes A, Hardie AD. Iodine quantification of renal lesions: Preliminary results using spectral-based material extraction on photon-counting CT. J Clin Imaging Sci. 2024;14:7. doi:10.25259/JCIS_1_2024
