Kevin G King1, Mittul Gulati2, Harshawn Malhi2, Darryl Hwang2, Inderbir S Gill3, Phillip M Cheng2, Edward G Grant2, Vinay A Duddalwar2. 1. Department of Radiology, Keck USC School of Medicine, 1500 San Pablo St, 2nd Floor Imaging, Los Angeles, CA, 90033, USA. kevingeorgeking@gmail.com. 2. Department of Radiology, Keck USC School of Medicine, 1500 San Pablo St, 2nd Floor Imaging, Los Angeles, CA, 90033, USA. 3. Department of Urology, Keck USC School of Medicine, 1500 San Pablo St, Los Angeles, CA, 90033, USA.
Abstract
PURPOSE: To discuss the evaluation of the enhancement curve over time of the major renal cell carcinoma (RCC) subtypes, oncocytoma, and lipid-poor angiomyolipoma, to aid in the preoperative differentiation of these entities. Differentiation of these lesions is important, given the different prognoses of the subtypes, as well as the desire to avoid resecting benign lesions. METHODS: We discuss findings from CT, MR, and US, but with a special emphasis on contrast-enhanced ultrasound (CEUS). CEUS technique is described, as well as time-intensity curve analysis. RESULTS: Examples of each of the major RCC subtypes (clear cell, papillary, and chromophobe) are shown, as well as examples of oncocytoma and lipid-poor angiomyolipoma. For each lesion, the time-intensity curve of enhancement on CEUS is reviewed, and correlated with the enhancement curve over time reported for multiphase CT and MR. CONCLUSIONS: Preoperative differentiation of the most common solid renal masses is important, and the time-intensity curves of these lesions show some distinguishing features that can aid in this differentiation. The use of CEUS is increasing, and as a modality it is especially well suited to the evaluation of the time-intensity curve.
PURPOSE: To discuss the evaluation of the enhancement curve over time of the major renal cell carcinoma (RCC) subtypes, oncocytoma, and lipid-poor angiomyolipoma, to aid in the preoperative differentiation of these entities. Differentiation of these lesions is important, given the different prognoses of the subtypes, as well as the desire to avoid resecting benign lesions. METHODS: We discuss findings from CT, MR, and US, but with a special emphasis on contrast-enhanced ultrasound (CEUS). CEUS technique is described, as well as time-intensity curve analysis. RESULTS: Examples of each of the major RCC subtypes (clear cell, papillary, and chromophobe) are shown, as well as examples of oncocytoma and lipid-poor angiomyolipoma. For each lesion, the time-intensity curve of enhancement on CEUS is reviewed, and correlated with the enhancement curve over time reported for multiphase CT and MR. CONCLUSIONS: Preoperative differentiation of the most common solid renal masses is important, and the time-intensity curves of these lesions show some distinguishing features that can aid in this differentiation. The use of CEUS is increasing, and as a modality it is especially well suited to the evaluation of the time-intensity curve.
Authors: Wolfgang M Thaiss; Jens Bedke; Stephan Kruck; Daniel Spira; Arnulf Stenzl; Konstantin Nikolaou; Marius Horger; Sascha Kaufmann Journal: World J Urol Date: 2018-10-15 Impact factor: 4.226
Authors: Sandeep K Kasoji; Emily H Chang; Lee B Mullin; Wui K Chong; W Kimryn Rathmell; Paul A Dayton Journal: Ultrason Imaging Date: 2016-09-22 Impact factor: 1.578
Authors: Toshitaka Shin; Vinay A Duddalwar; Osamu Ukimura; Toru Matsugasumi; Frank Chen; Nariman Ahmadi; Andre Luis de Castro Abreu; Hiromitsu Mimata; Inderbir S Gill Journal: Urol Int Date: 2017-03-08 Impact factor: 2.089