Fatemeh Homayounieh, Nikhil Gopal, Fatemeh Dehghani Firouzabadi, Pooyan Sahbaee, Pouria Yazdian, Moozhan Nikpanah, Michael Do, Muyang Wang, Rabindra Gautam, Mark W Ball, William F Pritchard, Elizabeth C Jones, Han Wen, W Marston Linehan, Evrim B Turkbey, Ashkan A Malayeri
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Of the 24 patients, 17 had a germline mutation and the remainder were sporadic cases. Two radiologists (R1 and R2) assessed the PCCT and corresponding MRI studies with a 3-week washout period between reviews. Readers recorded the number of lesions in each patient and graded each targeted lesion's characteristic features, dimensions, and location. Data were analyzed using a 2-sample t test, Fisher exact test, and weighted kappa.</p><p><strong>Results: </strong>In patients with von Hippel-Lindau mutation, R1 identified a similar number of lesions suspicious for neoplasm on both modalities (51 vs 50, P = 0.94), whereas R2 identified more suspicious lesions on PCCT scans as compared with MRI studies (80 vs 56, P = 0.12). R1 and R2 characterized more lesions as predominantly solid in MRIs (R1: 58/70 in MRI vs 52/70 in PCCT, P < 0.001; R2: 60/70 in MRI vs 55/70 in PCCT, P < 0.001). R1 and R2 performed similarly in detecting neoplastic lesions on PCCT and MRI studies (R1: 94% vs 90%, P = 0.5; R2: 73% vs 79%, P = 0.13).</p><p><strong>Conclusions: </strong>The interreader reliability and per-RCC sensitivity of PCCT scans acquired on an investigational whole-body PCCT were comparable to MRI scans in detecting and characterizing renal masses.</p><p><strong>Clinical relevance statement: </strong>PCCT scans have comparable performance to MRI studies while allowing for improved characterization of the internal composition of lesions due to material decomposition analysis. 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引用次数: 0
摘要
研究目的本研究旨在评估高分辨率光子计数计算机断层扫描（PCCT）与核磁共振成像（MRI）相比，在肾肿块的检测和定性方面的阅片人之间的可靠性和每个肾肿块的灵敏度：这项前瞻性研究纳入了 24 名成年患者（平均年龄 52 ± 14 岁；14 名女性），他们在 3 个月的时间间隔内接受了 PCCT（使用研究用全身 CT 扫描仪）和腹部 MRI 检查，并接受了手术切除（部分或根治性肾切除术）和组织病理学检查（n = 70 个病灶）。在这 24 名患者中，17 人有基因突变，其余为散发性病例。两名放射科医生（R1 和 R2）对 PCCT 和相应的 MRI 研究进行评估，两次评估之间有 3 周的间隔期。阅读者记录每位患者的病变数量，并对每个目标病变的特征、尺寸和位置进行分级。数据分析采用双样本 t 检验、费雪精确检验和加权卡帕法：在von Hippel-Lindau基因突变患者中，R1和R2在两种模式下发现的可疑肿瘤病灶数量相似（51 vs 50，P = 0.94），而R2在PCCT扫描中发现的可疑病灶数量多于核磁共振成像研究（80 vs 56，P = 0.12）。R1 和 R2 在核磁共振成像中将更多病灶定性为以实性为主（R1：核磁共振成像 58/70 vs PCCT 52/70，P < 0.001；R2：核磁共振成像 60/70 vs PCCT 55/70，P < 0.001）：核磁共振成像为 60/70 vs PCCT 为 55/70，P < 0.001）。R1和R2在检测PCCT和MRI研究中的肿瘤病变方面表现相似（R1：94% vs 90%，P = 0.5；R2：73% vs 79%，P = 0.13）：结论：在检测和描述肾肿块方面，研究性全身PCCT获得的PCCT扫描的读片机间可靠性和每个RCC的灵敏度与MRI扫描相当：PCCT 扫描的性能与核磁共振成像研究不相上下，同时通过材料分解分析，还能更好地描述病变的内部组成。这种成像模式的下一代产品可能会显示出 PCCT 相对于核磁共振成像的更多优势。
A Prospective Study of the Diagnostic Performance of Photon-Counting CT Compared With MRI in the Characterization of Renal Masses.
Objectives: The aim of this study was to assess the interreader reliability and per-RCC sensitivity of high-resolution photon-counting computed tomography (PCCT) in the detection and characterization of renal masses in comparison to MRI.
Materials and methods: This prospective study included 24 adult patients (mean age, 52 ± 14 years; 14 females) who underwent PCCT (using an investigational whole-body CT scanner) and abdominal MRI within a 3-month time interval and underwent surgical resection (partial or radical nephrectomy) with histopathology (n = 70 lesions). Of the 24 patients, 17 had a germline mutation and the remainder were sporadic cases. Two radiologists (R1 and R2) assessed the PCCT and corresponding MRI studies with a 3-week washout period between reviews. Readers recorded the number of lesions in each patient and graded each targeted lesion's characteristic features, dimensions, and location. Data were analyzed using a 2-sample t test, Fisher exact test, and weighted kappa.
Results: In patients with von Hippel-Lindau mutation, R1 identified a similar number of lesions suspicious for neoplasm on both modalities (51 vs 50, P = 0.94), whereas R2 identified more suspicious lesions on PCCT scans as compared with MRI studies (80 vs 56, P = 0.12). R1 and R2 characterized more lesions as predominantly solid in MRIs (R1: 58/70 in MRI vs 52/70 in PCCT, P < 0.001; R2: 60/70 in MRI vs 55/70 in PCCT, P < 0.001). R1 and R2 performed similarly in detecting neoplastic lesions on PCCT and MRI studies (R1: 94% vs 90%, P = 0.5; R2: 73% vs 79%, P = 0.13).
Conclusions: The interreader reliability and per-RCC sensitivity of PCCT scans acquired on an investigational whole-body PCCT were comparable to MRI scans in detecting and characterizing renal masses.
Clinical relevance statement: PCCT scans have comparable performance to MRI studies while allowing for improved characterization of the internal composition of lesions due to material decomposition analysis. Future generations of this imaging modality may reveal additional advantages of PCCT over MRI.
期刊介绍：
Investigative Radiology publishes original, peer-reviewed reports on clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, and related modalities. Emphasis is on early and timely publication. Primarily research-oriented, the journal also includes a wide variety of features of interest to clinical radiologists.
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