Abstract
Objectives
To evaluate the diagnostic efficacy of dual source–dual energy CT (DECT) in the detection of neoplasia in patients with polycystic kidney disease (PKD).
Methods
A total of 21 patients with PKD underwent DECT on a dual source system, using kVp settings of Sn140/100 or 140/80. Colour-coded iodine maps and virtual unenhanced images were used to determine enhancement within cysts and to differentiate haemorrhagic from simple cysts. A cut-off of 15 HU was used as a threshold for malignancy. In patients with malignancy, histopathology was the gold standard; otherwise, patients underwent follow-up imaging for 150–908 days.
Results
On the basis of measured enhancement, 13 enhancing masses were seen in 4 patients (12 renal cell cancers and 1 adenoma); follow-up imaging showed no malignancy in 18 patients. Cysts did not enhance by more than 15 HU, whereas masses showed a mean enhancement of 45 (25–123) HU. Average radiation exposure was 9.6 mSv for the biphasic protocol and 5.8 mSv for DECT only.
Conclusion
DECT greatly facilitates the detection of malignancy in patients with polycystic kidney disease, at the same time reducing radiation exposure by omission of a true unenhanced phase.
Key Points
• Identification of tumours within polycystic kidneys can be difficult.
• Dual energy computed tomography (DECT) provides two separate sets of images.
• Iodine maps and virtual non-enhanced (VNE) images can then be calculated.
• DECT facilitates screening for potential renal tumours in polycystic kidneys.
This is a preview of subscription content, log in via an institution to check access.
References
Johnson TR, Krauss B, Sedlmair M et al (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517
Graser A, Johnson TR, Hecht EM et al (2009) Dual-energy CT in patients suspected of having renal masses: can virtual nonenhanced images replace true nonenhanced images? Radiology 252:433–440
Graser A, Johnson TR, Chandarana H, Macari M (2009) Dual energy CT: preliminary observations and potential clinical applications in the abdomen. Eur Radiol 19:13–23
Graser A, Becker CR, Staehler M et al (2010) Single-phase dual-energy CT allows for characterization of renal masses as benign or malignant. Invest Radiol 45:399–405
Hajj P, Ferlicot S, Massoud W et al (2009) Prevalence of renal cell carcinoma in patients with autosomal dominant polycystic kidney disease and chronic renal failure. Urology 74:631–634
Hateboer N, van Dijk MA, Bogdanova N et al (1999) Comparison of phenotypes of polycystic kidney disease types 1 and 2. European PKD1-PKD2 study group. Lancet 353:103–107
Chapman AB (2011) Acquired cystic disease of the kidney in adults. http://www.uptodate.com/index. Accessed May 2011
Brenner DJ, Hall EJ (2007) Computed tomography – an increasing source of radiation exposure. N Engl J Med 357:2277–2284
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Arndt, N., Staehler, M., Siegert, S. et al. Dual energy CT in patients with polycystic kidney disease. Eur Radiol 22, 2125–2129 (2012). https://doi.org/10.1007/s00330-012-2481-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-012-2481-7