Virtual monochromatic spectral attenuation curve analysis for evaluation of incidentally detected small renal lesions using rapid kilovoltage-switching dual-energy computed tomography

摘要

Abstract Purpose To determine whether the spectral attenuation curve on a rapid kilovoltage-switching dual-energy computed tomography (DECT) scan can distinguish enhancing from nonenhancing incidental small (1–4?cm) renal lesions compared with conventional single-energy attenuation changes.Methods This retrospective study enrolled 46 patients with 78 renal lesions (24 enhancing; 54 nonenhancing) who underwent DECT with DE mode performed during the portovenous or nephrographic phase. Final diagnosis of enhancing and nonenhancing masses was confirmed by pathology or imaging following the established criteria. Virtual monochromatic images (VMI) were reconstructed, and the slopes between the VMI dataset at 40–70?keV (Slope HU40–70), 40–100?keV (Slope HU40–100), and 40–140?keV (Slope HU40–140) were measured. Visual assessment of the curve pattern was recorded. Diagnostic accuracies were calculated with a cross-validated Mann–Whitney U test, and correlations of quantitative spectral parameters and intraclass correlation coefficient (ICC) were calculated using Spearman’s rho correlation.Results All quantitative and qualitative spectral analysis parameters significantly differentiated the enhancing and nonenhancing lesions (P?