Diagnostic value multimodal parameter imaging based on spectral CT in differentiating renal cell carcinoma from renal angiomyolipoma

XI Xiaoxu; CHEN Zhiye

doi:10.12122/j.issn.1674-4500.2025.02.14

Abstract：Objective To investigate the diagnostic value of spectral CT quantitative enhancement parameters arterial enhancement fraction(AEF)and extracellular volume(ECV)in the differential diagnosis of renal cell carcinoma and renal angiomyolipoma.Methods The spectral base data of 54 patients with renal cell carcinoma and renal angiomyolipoma who underwent three-phase enhanced spectral CT in the Department of Radiology,Hainan Hospital of General Hospital of Chinese PLA from January 2021 to May 2024 were analyzed.The arterial enhancement fraction(AEF)map and extracellular volume(ECV)map were generated,the AEF and ECV values of tumor and contralateral normal renal cortex were measured respectively.The independent sample t test and Mann-Whitney U test were applied for inter-group comparisons,and ROC curve was used to evaluate the diagnostic efficacy.Results The AEF and ECV values of RCC were presented significantly more highly than those of RAML(PAEF<0.0001,PECV<0.0001).There was no significant difference in AEF value between RCC and contralateral normal kidney cortex(P=0.406).The ECV value of RCC was significantly lower than that of contralateral normal kidney cortex(P<0.0001).The AEF and ECV values of RAML were lower than those of contralateral normal kidney cortex(PAEF<0.0001,PECV<0.0001).The area under the ROC curve of AEF and ECV in the diagnosis of RCC was 0.566 and 0.992.The sensitivity and specificity of AEF were 37.1%and 85.2%.The sensitivity and specificity of ECV were 96.3%and 100%.The area under the ROC curve of AEF and ECV in the diagnosis of RAML was 0.818 and 1.000.The sensitivity and specificity of AEF were 77.8%and 88.9%.The sensitivity and specificity of ECV were both 100%.Conclusion Spectral CT quantitative enhancement parameters AEF and ECV can not only detect renal cell carcinoma and renal angiomyolipoma,but also have high diagnostic value for the identification of them.