Prevalence of solid tumors in incidentally detected homogeneous renal masses measuring > 20 HU on portal venous phase CT

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Abstract

OBJECTIVE. The purpose of this study was to determine the prevalence of solid tumors in incidental homogeneous renal masses with attenuation greater than 20 HU on portal venous phase CT images. MATERIALS AND METHODS. In this retrospective study, the records of patients with incidental indeterminate (> 20 HU) homogeneous renal masses on portal venous phase CT scans from September 11, 2007, through March 18, 2017, were identified. Adult patients were included if they had undergone follow-up ultrasound, contrast-enhanced MRI, multiphase contrast-enhanced CT, or pathologic analysis alone to confirm the solid or cystic nature of the lesion. A single ROI was placed in the center of the mass, and lesions were characterized as ≥ 50% exophytic, < 50% exophytic, or entirely surrounded by renal parenchyma. RESULTS. There were 322 masses in 267 patients. The mean lesion size was 16.6 (SD, 9.8) mm (range, 9–45 mm). Lesions were ≥ 50% exophytic in 92 cases, < 50% exophytic in 111 cases, and completely surrounded by renal parenchyma in 119 cases. All nonsolid lesions were characterized as benign cysts. The numbers of solid lesions per total number of lesions in each attenuation group were: 20–30 HU (0/140), 30–40 HU (0/67), 40–50 HU (1/38), 50–60 HU (3/24), 60–70 HU (5/17), 70–80 HU (5/17), and > 80 HU (8/19). All 207 lesions in the 20- to 40-HU range were benign cysts with no solid lesions (0%; 95% CI, 0.0–1.4%). CONCLUSION. Small homogeneous renal masses measuring 20–40 HU on portal venous phase CT images are highly likely to be benign cysts.

Original languageEnglish (US)
Pages (from-to)W173-W177
JournalAmerican Journal of Roentgenology
Volume211
Issue number3
DOIs
StatePublished - Sep 1 2018

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Kidney
Cysts
Neoplasms
Retrospective Studies

Keywords

  • High-attenuation cyst
  • Indeterminate
  • Renal cell carcinoma
  • Renal cyst
  • Renal mass

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{2028f1ba399f409b98f38c7d83966b9a,
title = "Prevalence of solid tumors in incidentally detected homogeneous renal masses measuring > 20 HU on portal venous phase CT",
abstract = "OBJECTIVE. The purpose of this study was to determine the prevalence of solid tumors in incidental homogeneous renal masses with attenuation greater than 20 HU on portal venous phase CT images. MATERIALS AND METHODS. In this retrospective study, the records of patients with incidental indeterminate (> 20 HU) homogeneous renal masses on portal venous phase CT scans from September 11, 2007, through March 18, 2017, were identified. Adult patients were included if they had undergone follow-up ultrasound, contrast-enhanced MRI, multiphase contrast-enhanced CT, or pathologic analysis alone to confirm the solid or cystic nature of the lesion. A single ROI was placed in the center of the mass, and lesions were characterized as ≥ 50{\%} exophytic, < 50{\%} exophytic, or entirely surrounded by renal parenchyma. RESULTS. There were 322 masses in 267 patients. The mean lesion size was 16.6 (SD, 9.8) mm (range, 9–45 mm). Lesions were ≥ 50{\%} exophytic in 92 cases, < 50{\%} exophytic in 111 cases, and completely surrounded by renal parenchyma in 119 cases. All nonsolid lesions were characterized as benign cysts. The numbers of solid lesions per total number of lesions in each attenuation group were: 20–30 HU (0/140), 30–40 HU (0/67), 40–50 HU (1/38), 50–60 HU (3/24), 60–70 HU (5/17), 70–80 HU (5/17), and > 80 HU (8/19). All 207 lesions in the 20- to 40-HU range were benign cysts with no solid lesions (0{\%}; 95{\%} CI, 0.0–1.4{\%}). CONCLUSION. Small homogeneous renal masses measuring 20–40 HU on portal venous phase CT images are highly likely to be benign cysts.",
keywords = "High-attenuation cyst, Indeterminate, Renal cell carcinoma, Renal cyst, Renal mass",
author = "Corwin, {Michael T} and Hansra, {Shan S.} and Loehfelm, {Thomas W} and Ramit Lamba and Ghaneh Fananapazir",
year = "2018",
month = "9",
day = "1",
doi = "10.2214/AJR.17.19351",
language = "English (US)",
volume = "211",
pages = "W173--W177",
journal = "American Journal of Roentgenology",
issn = "0361-803X",
publisher = "American Roentgen Ray Society",
number = "3",

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TY - JOUR

T1 - Prevalence of solid tumors in incidentally detected homogeneous renal masses measuring > 20 HU on portal venous phase CT

AU - Corwin, Michael T

AU - Hansra, Shan S.

AU - Loehfelm, Thomas W

AU - Lamba, Ramit

AU - Fananapazir, Ghaneh

PY - 2018/9/1

Y1 - 2018/9/1

N2 - OBJECTIVE. The purpose of this study was to determine the prevalence of solid tumors in incidental homogeneous renal masses with attenuation greater than 20 HU on portal venous phase CT images. MATERIALS AND METHODS. In this retrospective study, the records of patients with incidental indeterminate (> 20 HU) homogeneous renal masses on portal venous phase CT scans from September 11, 2007, through March 18, 2017, were identified. Adult patients were included if they had undergone follow-up ultrasound, contrast-enhanced MRI, multiphase contrast-enhanced CT, or pathologic analysis alone to confirm the solid or cystic nature of the lesion. A single ROI was placed in the center of the mass, and lesions were characterized as ≥ 50% exophytic, < 50% exophytic, or entirely surrounded by renal parenchyma. RESULTS. There were 322 masses in 267 patients. The mean lesion size was 16.6 (SD, 9.8) mm (range, 9–45 mm). Lesions were ≥ 50% exophytic in 92 cases, < 50% exophytic in 111 cases, and completely surrounded by renal parenchyma in 119 cases. All nonsolid lesions were characterized as benign cysts. The numbers of solid lesions per total number of lesions in each attenuation group were: 20–30 HU (0/140), 30–40 HU (0/67), 40–50 HU (1/38), 50–60 HU (3/24), 60–70 HU (5/17), 70–80 HU (5/17), and > 80 HU (8/19). All 207 lesions in the 20- to 40-HU range were benign cysts with no solid lesions (0%; 95% CI, 0.0–1.4%). CONCLUSION. Small homogeneous renal masses measuring 20–40 HU on portal venous phase CT images are highly likely to be benign cysts.

AB - OBJECTIVE. The purpose of this study was to determine the prevalence of solid tumors in incidental homogeneous renal masses with attenuation greater than 20 HU on portal venous phase CT images. MATERIALS AND METHODS. In this retrospective study, the records of patients with incidental indeterminate (> 20 HU) homogeneous renal masses on portal venous phase CT scans from September 11, 2007, through March 18, 2017, were identified. Adult patients were included if they had undergone follow-up ultrasound, contrast-enhanced MRI, multiphase contrast-enhanced CT, or pathologic analysis alone to confirm the solid or cystic nature of the lesion. A single ROI was placed in the center of the mass, and lesions were characterized as ≥ 50% exophytic, < 50% exophytic, or entirely surrounded by renal parenchyma. RESULTS. There were 322 masses in 267 patients. The mean lesion size was 16.6 (SD, 9.8) mm (range, 9–45 mm). Lesions were ≥ 50% exophytic in 92 cases, < 50% exophytic in 111 cases, and completely surrounded by renal parenchyma in 119 cases. All nonsolid lesions were characterized as benign cysts. The numbers of solid lesions per total number of lesions in each attenuation group were: 20–30 HU (0/140), 30–40 HU (0/67), 40–50 HU (1/38), 50–60 HU (3/24), 60–70 HU (5/17), 70–80 HU (5/17), and > 80 HU (8/19). All 207 lesions in the 20- to 40-HU range were benign cysts with no solid lesions (0%; 95% CI, 0.0–1.4%). CONCLUSION. Small homogeneous renal masses measuring 20–40 HU on portal venous phase CT images are highly likely to be benign cysts.

KW - High-attenuation cyst

KW - Indeterminate

KW - Renal cell carcinoma

KW - Renal cyst

KW - Renal mass

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U2 - 10.2214/AJR.17.19351

DO - 10.2214/AJR.17.19351

M3 - Article

C2 - 29995501

AN - SCOPUS:85052561758

VL - 211

SP - W173-W177

JO - American Journal of Roentgenology

JF - American Journal of Roentgenology

SN - 0361-803X

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