A Prospective Study of the Diagnostic Performance of Photon-Counting CT Compared With MRI in the Characterization of Renal Masses

作者：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 Türkbey, Ashkan A. Malayeri · 发表于：Investigative Radiology · 年份：2024 · DOI：10.1097/rli.0000000000001087 · 被引用次数：12 · 研究领域：Advanced X-ray and CT Imaging、Renal cell carcinoma treatment、Renal and Vascular Pathologies

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...