Quantitative differentiation of minimal-fat angiomyolipomas from renal cell carcinomas using grating-based x-ray phase-contrast computed tomography: An ex vivo study.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2023
Historique:
received: 04 12 2022
accepted: 03 04 2023
medline: 18 4 2023
entrez: 14 4 2023
pubmed: 15 4 2023
Statut: epublish

Résumé

The differentiation of minimal-fat-or low-fat-angiomyolipomas from other renal lesions is clinically challenging in conventional computed tomography. In this work, we have assessed the potential of grating-based x-ray phase-contrast computed tomography (GBPC-CT) for visualization and quantitative differentiation of minimal-fat angiomyolipomas (mfAMLs) and oncocytomas from renal cell carcinomas (RCCs) on ex vivo renal samples. Laboratory GBPC-CT was performed at 40 kVp on 28 ex vivo kidney specimens including five angiomyolipomas with three minimal-fat (mfAMLs) and two high-fat (hfAMLs) subtypes as well as three oncocytomas and 20 RCCs with eight clear cell (ccRCCs), seven papillary (pRCCs) and five chromophobe RCC (chrRCC) subtypes. Quantitative values of conventional Hounsfield units (HU) and phase-contrast Hounsfield units (HUp) were determined and histogram analysis was performed on GBPC-CT and grating-based attenuation-contrast computed tomography (GBAC-CT) slices for each specimen. For comparison, the same specimens were imaged at a 3T magnetic resonance imaging (MRI) scanner. We have successfully matched GBPC-CT images with clinical MRI and histology, as GBPC-CT presented with increased soft tissue contrast compared to absorption-based images. GBPC-CT images revealed a qualitative and quantitative difference between mfAML samples (58±4 HUp) and oncocytomas (44±10 HUp, p = 0.057) and RCCs (ccRCCs: 40±12 HUp, p = 0.012; pRCCs: 43±9 HUp, p = 0.017; chrRCCs: 40±7 HUp, p = 0.057) in contrast to corresponding laboratory attenuation-contrast CT and clinical MRI, although not all differences were statistically significant. Due to the heterogeneity and lower signal of oncocytomas, quantitative differentiation of the samples based on HUp or in combination with HUs was not possible. GBPC-CT allows quantitative differentiation of minimal-fat angiomyolipomas from pRCCs and ccRCCs in contrast to absorption-based imaging and clinical MRI.

Sections du résumé

BACKGROUND
The differentiation of minimal-fat-or low-fat-angiomyolipomas from other renal lesions is clinically challenging in conventional computed tomography. In this work, we have assessed the potential of grating-based x-ray phase-contrast computed tomography (GBPC-CT) for visualization and quantitative differentiation of minimal-fat angiomyolipomas (mfAMLs) and oncocytomas from renal cell carcinomas (RCCs) on ex vivo renal samples.
MATERIALS AND METHODS
Laboratory GBPC-CT was performed at 40 kVp on 28 ex vivo kidney specimens including five angiomyolipomas with three minimal-fat (mfAMLs) and two high-fat (hfAMLs) subtypes as well as three oncocytomas and 20 RCCs with eight clear cell (ccRCCs), seven papillary (pRCCs) and five chromophobe RCC (chrRCC) subtypes. Quantitative values of conventional Hounsfield units (HU) and phase-contrast Hounsfield units (HUp) were determined and histogram analysis was performed on GBPC-CT and grating-based attenuation-contrast computed tomography (GBAC-CT) slices for each specimen. For comparison, the same specimens were imaged at a 3T magnetic resonance imaging (MRI) scanner.
RESULTS
We have successfully matched GBPC-CT images with clinical MRI and histology, as GBPC-CT presented with increased soft tissue contrast compared to absorption-based images. GBPC-CT images revealed a qualitative and quantitative difference between mfAML samples (58±4 HUp) and oncocytomas (44±10 HUp, p = 0.057) and RCCs (ccRCCs: 40±12 HUp, p = 0.012; pRCCs: 43±9 HUp, p = 0.017; chrRCCs: 40±7 HUp, p = 0.057) in contrast to corresponding laboratory attenuation-contrast CT and clinical MRI, although not all differences were statistically significant. Due to the heterogeneity and lower signal of oncocytomas, quantitative differentiation of the samples based on HUp or in combination with HUs was not possible.
CONCLUSIONS
GBPC-CT allows quantitative differentiation of minimal-fat angiomyolipomas from pRCCs and ccRCCs in contrast to absorption-based imaging and clinical MRI.

Identifiants

pubmed: 37058505
doi: 10.1371/journal.pone.0279323
pii: PONE-D-22-31191
pmc: PMC10104346
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0279323

Informations de copyright

Copyright: © 2023 Birnbacher et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Lorenz Birnbacher (L)

Chair of Biomedical Physics, School of Natural Sciences & Department of Physics, Munich Institute of Biomedical Engineering, Technical University of Munich, München, Germany.
Institute of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, München, Germany.

Margarita Braunagel (M)

Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, München, Germany.

Marian Willner (M)

Chair of Biomedical Physics, School of Natural Sciences & Department of Physics, Munich Institute of Biomedical Engineering, Technical University of Munich, München, Germany.

Mathias Marschner (M)

Chair of Biomedical Physics, School of Natural Sciences & Department of Physics, Munich Institute of Biomedical Engineering, Technical University of Munich, München, Germany.

Fabio De Marco (F)

Chair of Biomedical Physics, School of Natural Sciences & Department of Physics, Munich Institute of Biomedical Engineering, Technical University of Munich, München, Germany.
Department of Physics, University of Trieste, Trieste TS, Italy.

Manuel Viermetz (M)

Chair of Biomedical Physics, School of Natural Sciences & Department of Physics, Munich Institute of Biomedical Engineering, Technical University of Munich, München, Germany.

Sigrid Auweter (S)

Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, München, Germany.

Susan Notohamiprodjo (S)

Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, München, Germany.
Department of Nuclear Medicine, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, München, Germany.

Katharina Hellbach (K)

Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, München, Germany.
Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Ruprecht-Karls-University Heidelberg, München, Germany.

Mike Notohamiprodjo (M)

Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, München, Germany.

Michael Staehler (M)

Institute of Urology, Ludwig-Maximilians-University Hospital Munich, München, Germany.

Daniela Pfeiffer (D)

Institute of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, München, Germany.
Institute of Advanced Study, Technical University of Munich, München, Germany.

Maximilian F Reiser (MF)

Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, München, Germany.

Franz Pfeiffer (F)

Chair of Biomedical Physics, School of Natural Sciences & Department of Physics, Munich Institute of Biomedical Engineering, Technical University of Munich, München, Germany.
Institute of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, München, Germany.
Institute of Advanced Study, Technical University of Munich, München, Germany.

Julia Herzen (J)

Chair of Biomedical Physics, School of Natural Sciences & Department of Physics, Munich Institute of Biomedical Engineering, Technical University of Munich, München, Germany.

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