Morphologic analysis with computed tomography may help differentiate fat-poor angiomyolipoma from renal cell carcinoma: a retrospective study with 602 patients

Yong Hee Kim, Kyunghwa Han, Young Taik Oh, Dae Chul Jung, Nam Hoon Cho, Sung Yoon Park

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: To assess whether morphologic analysis using computed tomography (CT) could differentiate between fat-poor angiomyolipoma (fpAML) and renal cell carcinoma (RCC). Methods: A total of 602 patients with a histologically confirmed fpAML (n = 49) or RCC (n = 553) were evaluated. All renal lesions were less than 4 cm in size and had no gross fat on contrast-enhanced CT. For morphologic analysis, overflowing beer sign and angular interface were evaluated. Overflowing beer sign was defined as contact length between bulging-out portion of a mass and the adjacent renal capsule of 3 mm or greater. Angular interface was defined as the angle of parenchymal portion of a mass of 90° or less. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were assessed. Multivariate analysis was conducted to determine which variable is predictive of fpAML. Results: Sensitivity, specificity, PPV, NPV, and accuracy were 61.2% (30/49), 97.1% (537/553), 65.2% (30/46), 96.6% (537/556), and 94.2% (567/602) with overflowing beer sign, while they were 55.1% (27/49), 81.9% (453/553), 21.3% (27/127), 95.4% (453/475), and 79.7% (480/602) with angular interface for fpAML, respectively. Both CT variables were predictive of fpAML (overflowing beer sign, odds ratio = 132.881, p < 0.001; angular interface, odds ratio = 5.766, p = 0.010). The multivariate model with CT variables showed good performance for predicting fpAML (AUC, 0.871 with angular interface, 0.943 with overflowing beer sign, and 0.949 with both). Conclusion: Morphologic analysis with contrast-enhanced CT may be useful for differentiating fpAML from RCC. Overflowing beer sign has the potential as an imaging biomarker for fpAML.

Original languageEnglish
Pages (from-to)647-654
Number of pages8
JournalAbdominal Radiology
Volume43
Issue number3
DOIs
Publication statusPublished - 2018 Mar 1

Fingerprint

Angiomyolipoma
Renal Cell Carcinoma
Retrospective Studies
Fats
Tomography
Odds Ratio
Kidney
Sensitivity and Specificity
Area Under Curve
Capsules
Multivariate Analysis
Biomarkers

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

@article{6e67e6aed2654a3d83cdd4b5e51d470f,
title = "Morphologic analysis with computed tomography may help differentiate fat-poor angiomyolipoma from renal cell carcinoma: a retrospective study with 602 patients",
abstract = "Purpose: To assess whether morphologic analysis using computed tomography (CT) could differentiate between fat-poor angiomyolipoma (fpAML) and renal cell carcinoma (RCC). Methods: A total of 602 patients with a histologically confirmed fpAML (n = 49) or RCC (n = 553) were evaluated. All renal lesions were less than 4 cm in size and had no gross fat on contrast-enhanced CT. For morphologic analysis, overflowing beer sign and angular interface were evaluated. Overflowing beer sign was defined as contact length between bulging-out portion of a mass and the adjacent renal capsule of 3 mm or greater. Angular interface was defined as the angle of parenchymal portion of a mass of 90° or less. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were assessed. Multivariate analysis was conducted to determine which variable is predictive of fpAML. Results: Sensitivity, specificity, PPV, NPV, and accuracy were 61.2{\%} (30/49), 97.1{\%} (537/553), 65.2{\%} (30/46), 96.6{\%} (537/556), and 94.2{\%} (567/602) with overflowing beer sign, while they were 55.1{\%} (27/49), 81.9{\%} (453/553), 21.3{\%} (27/127), 95.4{\%} (453/475), and 79.7{\%} (480/602) with angular interface for fpAML, respectively. Both CT variables were predictive of fpAML (overflowing beer sign, odds ratio = 132.881, p < 0.001; angular interface, odds ratio = 5.766, p = 0.010). The multivariate model with CT variables showed good performance for predicting fpAML (AUC, 0.871 with angular interface, 0.943 with overflowing beer sign, and 0.949 with both). Conclusion: Morphologic analysis with contrast-enhanced CT may be useful for differentiating fpAML from RCC. Overflowing beer sign has the potential as an imaging biomarker for fpAML.",
author = "Kim, {Yong Hee} and Kyunghwa Han and Oh, {Young Taik} and Jung, {Dae Chul} and Cho, {Nam Hoon} and Park, {Sung Yoon}",
year = "2018",
month = "3",
day = "1",
doi = "10.1007/s00261-017-1244-y",
language = "English",
volume = "43",
pages = "647--654",
journal = "Abdominal Radiology",
issn = "2366-004X",
publisher = "Springer New York",
number = "3",

}

Morphologic analysis with computed tomography may help differentiate fat-poor angiomyolipoma from renal cell carcinoma : a retrospective study with 602 patients. / Kim, Yong Hee; Han, Kyunghwa; Oh, Young Taik; Jung, Dae Chul; Cho, Nam Hoon; Park, Sung Yoon.

In: Abdominal Radiology, Vol. 43, No. 3, 01.03.2018, p. 647-654.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Morphologic analysis with computed tomography may help differentiate fat-poor angiomyolipoma from renal cell carcinoma

T2 - a retrospective study with 602 patients

AU - Kim, Yong Hee

AU - Han, Kyunghwa

AU - Oh, Young Taik

AU - Jung, Dae Chul

AU - Cho, Nam Hoon

AU - Park, Sung Yoon

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Purpose: To assess whether morphologic analysis using computed tomography (CT) could differentiate between fat-poor angiomyolipoma (fpAML) and renal cell carcinoma (RCC). Methods: A total of 602 patients with a histologically confirmed fpAML (n = 49) or RCC (n = 553) were evaluated. All renal lesions were less than 4 cm in size and had no gross fat on contrast-enhanced CT. For morphologic analysis, overflowing beer sign and angular interface were evaluated. Overflowing beer sign was defined as contact length between bulging-out portion of a mass and the adjacent renal capsule of 3 mm or greater. Angular interface was defined as the angle of parenchymal portion of a mass of 90° or less. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were assessed. Multivariate analysis was conducted to determine which variable is predictive of fpAML. Results: Sensitivity, specificity, PPV, NPV, and accuracy were 61.2% (30/49), 97.1% (537/553), 65.2% (30/46), 96.6% (537/556), and 94.2% (567/602) with overflowing beer sign, while they were 55.1% (27/49), 81.9% (453/553), 21.3% (27/127), 95.4% (453/475), and 79.7% (480/602) with angular interface for fpAML, respectively. Both CT variables were predictive of fpAML (overflowing beer sign, odds ratio = 132.881, p < 0.001; angular interface, odds ratio = 5.766, p = 0.010). The multivariate model with CT variables showed good performance for predicting fpAML (AUC, 0.871 with angular interface, 0.943 with overflowing beer sign, and 0.949 with both). Conclusion: Morphologic analysis with contrast-enhanced CT may be useful for differentiating fpAML from RCC. Overflowing beer sign has the potential as an imaging biomarker for fpAML.

AB - Purpose: To assess whether morphologic analysis using computed tomography (CT) could differentiate between fat-poor angiomyolipoma (fpAML) and renal cell carcinoma (RCC). Methods: A total of 602 patients with a histologically confirmed fpAML (n = 49) or RCC (n = 553) were evaluated. All renal lesions were less than 4 cm in size and had no gross fat on contrast-enhanced CT. For morphologic analysis, overflowing beer sign and angular interface were evaluated. Overflowing beer sign was defined as contact length between bulging-out portion of a mass and the adjacent renal capsule of 3 mm or greater. Angular interface was defined as the angle of parenchymal portion of a mass of 90° or less. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were assessed. Multivariate analysis was conducted to determine which variable is predictive of fpAML. Results: Sensitivity, specificity, PPV, NPV, and accuracy were 61.2% (30/49), 97.1% (537/553), 65.2% (30/46), 96.6% (537/556), and 94.2% (567/602) with overflowing beer sign, while they were 55.1% (27/49), 81.9% (453/553), 21.3% (27/127), 95.4% (453/475), and 79.7% (480/602) with angular interface for fpAML, respectively. Both CT variables were predictive of fpAML (overflowing beer sign, odds ratio = 132.881, p < 0.001; angular interface, odds ratio = 5.766, p = 0.010). The multivariate model with CT variables showed good performance for predicting fpAML (AUC, 0.871 with angular interface, 0.943 with overflowing beer sign, and 0.949 with both). Conclusion: Morphologic analysis with contrast-enhanced CT may be useful for differentiating fpAML from RCC. Overflowing beer sign has the potential as an imaging biomarker for fpAML.

UR - http://www.scopus.com/inward/record.url?scp=85021819780&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021819780&partnerID=8YFLogxK

U2 - 10.1007/s00261-017-1244-y

DO - 10.1007/s00261-017-1244-y

M3 - Article

C2 - 28677004

AN - SCOPUS:85021819780

VL - 43

SP - 647

EP - 654

JO - Abdominal Radiology

JF - Abdominal Radiology

SN - 2366-004X

IS - 3

ER -