Korean J Urol.  2015 Oct;56(10):695-702. 10.4111/kju.2015.56.10.695.

Comparison of computed tomography findings between renal oncocytomas and chromophobe renal cell carcinomas

• Choi JH
• Kim JW
• Lee JY
• Han WK
• Rha KH
• Choi YD
• Hong SJ
• Yoon YE

• KMID: 2344112
• DOI: http://doi.org/10.4111/kju.2015.56.10.695

Abstract

PURPOSE
To investigate and distinguish the computed tomography (CT) characteristics of chromophobe renal cell carcinoma (chRCC) and renal oncocytoma.
MATERIALS AND METHODS
Fifty-one patients with renal oncocytoma and 120 patients with chRCC, diagnosed by surgery between November 2005 and June 2015, were studied retrospectively. Two observers, who were urologists and unaware of the pathological results, reviewed the preoperative CT images. The tumors were evaluated for size, laterality, tumor type (ball or bean pattern), central stellate scar, segmental enhancement inversion, and angular interface pattern and tumor complexity. To accurately analyze the mass-enhancing pattern of renal mass, we measured Hounsfield units (HUs) in each phase and analyzed the mean, maximum, and minimum HU values and standard deviations.
RESULTS
There were 51 renal oncocytomas and 120 chRCCs in the study cohort. No differences in clinical and demographic characteristics were observed between the two groups. A central stellate scar and segmental enhancement inversion were more likely in oncocytomas. However, there were no differences in ball-/bean-type categorization, enhancement pattern, and the shape of the interface between the groups. Higher HU values tended to be present in the corticomedullary and nephrogenic phases in oncocytomas than in chRCC. Receiver-operating characteristic curve analysis showed that the presence of a central stellate scar and higher mean HU values in the nephrogenic phase were highly predictive of renal oncocytoma (area under the curve=0.817, p<0.001).
CONCLUSIONS
The appearance of a central stellate scar and higher mean HU values in the nephrogenic phase could be useful to distinguish renal oncocytomas from chRCCs.

Keyword

Renal cell carcinoma; Renal oncocytoma; X-ray computed tomography

MeSH Terms

Adenoma, Oxyphilic/pathology/*radiography
Carcinoma, Renal Cell/pathology/*radiography
Diagnosis, Differential
Female
Humans
Kidney Neoplasms/pathology/*radiography
Male
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed

Figure

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  Fig. 1 Attenuations of 171 renal masses (51 oncocytomas and 120 chromophobe RCCs) on 3-phase computed tomography. HU, Hounsfield unit; RCC, renal cell carcinoma. *p<0.05.

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  Fig. 2 Attenuations of 84 renal masses (28 oncocytomas and 56 chromophobe RCCs) on 4-phase computed tomography. HU, Hounsfield unit; RCC, renal cell carcinoma. *p<0.05.

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