A retrospective review of the imaging results of 11 patients with 13 solid renal parenchymal neoplasms was performed, allowing analysis of the linear growth rates of these tumors. The study sample included seven pathologically proved renal adenocarcinomas and six lesions that were indicative of a neoplasm radiologically (enhancing parenchymal mass on computed tomographic [CT] scans with documented interval growth), which were followed up for 2-7.8 years. Variable interval tumor growth was demonstrated in every case except one and ranged from 0 to 1.6 cm/y, with an overall mean linear growth rate of approximately 0.5 cm/y. Ten of 11 "small renal neoplasms" (less than or equal to 3.0 cm in diameter) displayed interval growth, with five ultimately measuring greater than 3.0 cm (size range, 3.5-7.0 cm). While the results are preliminary and reflect observations on a very small study sample, it was noted that five of the seven pathologically proved adenocarcinomas appeared homogeneous and well marginated, and all were low-grade, low-stage carcinomas. These grew more slowly and were generally smaller at initial presentation than higher-grade lesions, which demonstrated a more heterogeneous appearance on CT scans.
Thirty-seven patients with 69 suspected hemangiomas found by means of computed tomography (CT) and/or ultrasound were studied with both 0.5-T magnetic resonance (MR) imaging and single photon emission CT (SPECT) with technetium-99m-labeled red blood cells. Using a criterion of "perfusion-blood pool mismatch," SPECT readers diagnosed 50 of 64 hemangiomas and all five "nonhemangiomas" (sensitivity, 78% [95% confidence interval, 0.664 - 0.864]; accuracy, 80% [0.69 - 0.877]). Qualitative analysis of lesion signal intensity on T2-weighted spin-echo MR images allowed readers to diagnose 58 of 64 hemangiomas and four of five nonhemangiomas (sensitivity, 91% [0.814 - 0.96]; accuracy, 90% [0.807 - 0.951]). Because of the significantly higher cost of MR imaging and its inability to categorically differentiate hemangiomas from hypervascular metastases, the authors consider SPECT to be the method of choice for diagnosing hepatic hemangiomas. MR imaging should be reserved for the diagnosis of lesions smaller than 2.0 cm and for those 2.5 cm and smaller adjacent to the heart or major hepatic vessels; in such cases MR imaging was found superior to SPECT.
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