Differential diagnosis of renal oncocytoma and chromophobe renal cell carcinoma using CT features: a central scar-matched retrospective study

Abstract

Background Renal oncocytoma (RO) and chromophobe renal cell carcinoma (chRCC) have a common cellular origin and different clinical management and prognosis. Purpose To explore the utility of computed tomography (CT) in the differentiation of RO and chRCC. Material and Methods Twenty-five patients with RO and 73 patients with chRCC presenting with the central scar were included retrospectively. Two experienced radiologists independently reviewed the CT imaging features, including location, tumor size, relative density ratio, segmental enhancement inversion (SEI), necrosis, and perirenal fascia thickening, among others. Interclass correlation coefficient (ICC, for continuous variables) or Kappa coefficient test (for categorical variables) was used to determine intra-observer and inter-observer bias between the two radiologists. Results The inter- and intra-reader reproducibility of the other CT imaging parameters were nearly perfect (>0.81) except for the measurements of fat (0.662). RO differed from chRCC in the cortical or medullary side ( P = 0.005), relative density ratio ( P = 0.020), SEI ( P < 0.001), and necrosis ( P = 0.045). The logistic regression model showed that location (right kidney), hypo-density on non-enhanced CT, SEI, and perirenal fascia thickening were highly predictive of RO. The combined indicators from logistic regression model were used for ROC analysis. The area under the ROC curve was 0.923 ( P < 0.001). The sensitivity and specificity of the four factors combined for diagnosing RO were 88% and 86.3%, respectively. The correlation coefficient between necrosis and tumor size in all tumors including both of RO and chRCC was 0.584, indicating a positive correlation ( P < 0.001). Conclusion The CT imaging features of location (right kidney), hypo-density on non-enhanced CT, SEI, and perirenal fascia thickening were valuable indicators in distinguishing RO from chRCC.

Four-phase computed tomography helps differentiation of renal oncocytoma with central hypodense areas from clear cell renal cell carcinoma

“…Third, complete enhancement inversion was observed only in the excretory phase. This explains why it has never been mentioned with CT before, since a longer delay scanning time was not used [5,18]. Cornelis et al [1] investigated the delayed enhancement features of central high T2-weighted signal intensity of oncocytomas and RCCs on MRI and first proposed the concept of enhancement inversion.…”

[Retracted] Application of CT Imaging in Differential Diagnosis and Nursing of Endocrine Tumors

“…Therefore, it also shows uneven enhancement under CT enhancement, as shown in Figure 2 . Tumor whole-body tomography: lung cancer screening [ 8 ].…”

Renal Oncocytoma: The Diagnostic Challenge to Unmask the Double of Renal Cancer

“…In 2021, a retrospective study by Li et al evaluated the diagnostic value of various CT-detected features in 25 patients with oncocytoma and in 73 with chRCC, all of which presented the classic stellate scar. A number of distinguishing findings positively correlated with the diagnosis of oncocytoma: right kidney location, hypodensity in non-contrast CT, segmental enhancement inversion (SEI) and thickening of the perirenal fascia [ 131 ].…”