scholarly journals Quantitative Analysis of Enhanced Computed Tomography in Differentiating Cystitis Glandularis and Bladder Cancer

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hui Hua ◽  
Yuanxiang Gao ◽  
Jizheng Lin ◽  
Feng Hou ◽  
Jun wei Wang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Quantitative Analysis ◽  
Sensitivity And Specificity ◽  
Arterial Phase ◽  
Relative Enhancement ◽  
Enhanced Ct ◽  
Venous Phase ◽  
Enhanced Computed Tomography ◽  
Quantitative Indicators ◽  
Delayed Phase

Objective. This study was performed to assess the value of quantitative analysis of enhanced computed tomography (CT) values in the differential diagnosis of bladder cancer and cystitis glandularis (CG). Methods. Eighty patients with bladder masses (39 with CG and 41 with bladder cancer) who underwent enhanced CT were retrospectively reviewed. The CT enhancement values of the lesion and normal bladder wall in the arterial phase, venous phase, and delayed phase were measured. The relative enhancement CT values (relative enhancement CT value=enhancement CT value of lesion−enhancement CT value of normal bladder) in the arterial phase, venous phase, and delayed phase were also calculated. The pathological results were used as the gold standard, and the area under the curve (AUC), sensitivity, and specificity were calculated for the six groups of quantitative indicators (enhanced CT values and relative enhanced CT values of CG and bladder cancer in the arterial, venous, and delayed phases). We performed the leave-group-out cross-validation method to validate the accuracy, AUC, sensitivity, and specificity. The differences in accuracy, AUC, sensitivity, and specificity among the six groups of quantitative indicators were compared by the t-test. Results. In a combined analysis of the AUC, sensitivity, and specificity performance, the best indicator was the arterial-phase relative enhancement CT value with a cut-off of 25.85 HU (AUC, 0.966; sensitivity, 95.1%; specificity, 92.3%). We used the 100-times leave-group-out cross-validation method to validate the accuracy, AUC, sensitivity, and specificity. Arterial-phase relative enhancement CT values showed the highest AUC and accuracy among the six groups, with statistical significance (P<0.05). Conclusion. Quantitative analysis of enhanced CT is of great clinical value in the differential diagnosis of CG and bladder cancer.

Case 5.6

2014 ◽  
pp. 253-253
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Abdominal Pain ◽  
Equilibrium Phase ◽  
Arterial Phase ◽  
Recurrent Pancreatitis ◽  
Portal Venous Phase ◽  
History Of ◽  
Venous Phase ◽  
Delayed Phase

37-year-old woman with a history of recurrent pancreatitis and abdominal pain Arterial phase (Figure 5.6.1A), portal venous phase (Figure 5.6.1B), equilibrium phase (Figure 5.6.1C), and 8-minute delayed phase (Figure 5.6.1D) postgadolinium 3D SPGR images show multiple splenic lesions that are initially hypoenhancing relative to adjacent spleen and become hyperintense on delayed images....

scholarly journals The Application of Dual-phase Enhanced CT Scan in Distinguishing Adrenal Ganglioneuromas From Adrenal Lipid-poor Adenomas

2021 ◽  
Author(s):  
Huajun Yu ◽  
Jian Wang ◽  
Zhongfeng Niu ◽  
Meihua Shao
Keyword(s):  
Ct Scan ◽  
Arterial Phase ◽  
Dual Phase ◽  
Operating Characteristics ◽  
Portal Venous Phase ◽  
Ct Value ◽  
Ct Findings ◽  
Imaging Characteristics ◽  
Enhanced Ct ◽  
Venous Phase

Abstract Background:The utility of dual-phase enhanced CT scan in distinguishing ganglioneuromas from lipid-poor adenomas has not been reported. We aimed to prospectively compare CT findings helpful in distinguishing adrenal ganglioneuromas from adrenal lipid-poor adenomas. Methods: We estimated the CT findings of 258 adrenal masses (42 ganglioneuromas, 216 lipid-poor adenomas) in 258 patients from July 2008 to July 2020 with ganglioneuromas and July 2016 to July 2020 with lipid-poor adenomas. The CT features between ganglioneuromas and lipid-poor adenomas were compared. Results:Significant differences were detected in CT value of unenhanced (CTU), CT value of arterial phase (CTA), CT value of venous phase (CTV), degree of enhancement in arterial phase (DEAP), degree of enhancement in portal venous phase (DEPP), age, tumor size [long diameter (LD), short diameter (SD), mean diameter (MD)], shape, calcification between the ganglioneuroma and lipid-poor adenoma groups (P < 0.05).The results of receiver operating characteristics (ROC) analyses showed that areas under ROC curves (AUC) of CTU, CTA and CTV were 0.713, 0.878, and 0.914, respectively. When the cut-off values were set at 22.5 HU, 51.5 HU, and 53.5 HU for CTU, CTA, and CTV, respectively the three parameters had a sensitivity of 46.8%, 67.6%, and 88.0% and a specificity of 100%, 100%, and 88.1% in distinguishing between ganglioneuromas and lipid-poor adenomas.Conclusion: Dual-phase enhanced abdominal CT can exhibit some of the primary imaging characteristics of ganglioneuromas and lipid-poor adenomas used to distinguish between these two entities.

scholarly journals Correlation of Small Bowel Gastrointestinal Stromal Tumor Computed Tomography Features with the Grade of Pathological Risk

2021 ◽  
Author(s):  
Yanfen Lan ◽  
Lixun Chen ◽  
Shaobin Chen ◽  
Mingping Ma
Keyword(s):  
Roc Curve ◽  
Risk Group ◽  
Low Risk ◽  
Arterial Phase ◽  
Stromal Tumors ◽  
Ct Value ◽  
Phase Increment ◽  
Venous Phase ◽  
Small Intestinal ◽  
Delayed Phase

Abstract Objectives: The aim of this study was to investigate the diagnostic value of computerized tomography (CT) features of small intestinal stromal tumors in terms of their degree of risk. Methods: The clinical data and CT data of 107 patients with small intestinal stromal tumors confirmed by surgery and pathology in our hospital from June 2012 to October 2020 were selected. According to the results of postoperative pathological risk, the patients were divided into high-risk and low-risk groups, wherein 67 cases were in high-risk group and 40 cases were in the low-risk group The maximum diameter, solid component plain scan, arterial phase CT value, venous phase CT value, and delayed phase CT value of the two groups were measured, and the enhancement degree of arterial phase, venous phase, delayed CT value, and lesion enhancement mode were calculated. The difference between the two groups was compared. An independent sample t-test was used to compare quantitative indices, and the chi-squared test or Fisher’s exact test was used for qualitative index comparison. A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of the arterial phase CT value, venous phase CT value, delayed phase CT value, arterial phase enhancement degree, venous phase enhancement degree, delayed phase enhancement degree, and the enhanced net value-added in the risk degree of SBGISTs. The relationship between preoperative imaging findings and tumor risk was retrospectively analyzed. Results: Univariate analysis showed that there were significant differences in the lesion location, growth pattern, lesion ulcer, necrotic cystic degeneration, lobulation, boundary with surrounding tissues, plain scan density and lesion enhancement mode, CT value in arterial phase, increment in arterial phase, CT value in venous phase, increment in venous phase, CT value in delayed phase, increment in delayed phase, and enhancement value in lesion between the two groups (P < 0.05); there were no significant differences in sex, age, calcification, bleeding, clinical symptoms, and CT value (P > 0.05). The ROC curve analysis showed that the area under the curve (AUC) of the long diameter of the lesion was 0.959 (P = 0.000), the optimal critical point of the ROC curve was the lesion ≥ 4.80 cm, the sensitivity was 88.1%, the specificity was 97.5%, and the accuracy was 91.6%; for the low-risk group, the AUC was 0.788 (the largest, P = 0.000), the sensitivity was 77.5%, the specificity was 70.1%, and the accuracy was 72.9%. Multivariate analysis showed that non-uniform density (P = 0.030; odds ratio [OR]: 12.544; 95% confidence interval [CI]: 1.269–123.969), arterial phase CT value (P = 0.024; OR: 10.790; 95% CI: 1.374–84.754), and lesion length (P = 0.000; OR: 648.694; 95% CI: 40.541–10,379.714) were risk factors for SBGISTs. Conclusions: The CT features of small intestinal stromal tumors have certain characteristics, which can help to grade the risk of small intestinal stromal tumors before surgery.

scholarly journals Quantitative Analysis of Hypervascular Hepatic Metastases and Hepatocellular Carcinoma using Spectral CT Imaging

2019 ◽  
Author(s):  
Zhiqiang Yang ◽  
Xinyi Wang ◽  
Hao Shi
Keyword(s):  
Hepatocellular Carcinoma ◽  
Quantitative Analysis ◽  
Spectral Curve ◽  
Iodine Concentration ◽  
Ct Imaging ◽  
Arterial Phase ◽  
Spectral Ct ◽  
Portal Venous Phase ◽  
Significant Difference ◽  
Venous Phase

Abstract Objective The goal of this study is to evaluate the performance of spectral CT-based quantitative analysis in differential diagnosis of hypervascular hepatic metastasis (HVHM) and hepatocellular carcinoma (HCC). Methods Spectral CT scans were performed for 47 patients with hepatic malignant tumors, including 20 patients with HVHM and 27 patients with HCC, which generated the following sets of data: single energy images in the arterial phase; iodine and water maps; marginal areas of lesions that manifested apparent signal intensification; and energy spectral parameters of normal liver tissues and abdominal aorta. Subsequently, we calculated the normalized iodine concentrations (NIC), lesion-normal parenchyma iodine concentration ratio (LNR), iodine concentration difference (ICD) between the arterial phase and the venous phase, and the spectral curve slope. An independent samples t test and receiver operating characteristic (ROC) curve analysis were applied to examine these quantitative parameters. Results In the arterial phase, the HVHM and HCC groups displayed no differences in NIC, LNR, or spectral curve slope (P > 0.05). In the venous phase, the two groups displayed significant differences in NIC, LNR, and spectral curve slope; the NIC was 0.59 ± 0.08 for the HVHM group and 0.4 5 ± 0.10 for the HCC group; the LNR was 1.17 ± 0.22 and 0.92 ± 0.16, respectively; the spectral curve slope was 1.85 ± 0.49 and 1.18 ± 0.34, respectively. In addition, there was no significant difference in ICD between the HVHM group (0.54 ± 0.39 g/L) and HCC group (0.45 ± 0.39 g/L) (P > 0.05). Finally, there were no significant differences of water or iodine concentration between the arterial phase and venous phase (P > 0.05). Taken together, the spectral curve slope in the portal venous phase had the best performance in differentiating HVHM from HCC. Conclusions HVHM and HCC have apparent differences in spectral curve and concentrations of radiocontrast agents in the portal venous phase. Hence, spectral CT imaging provides a new multiparameter quantitative approach for differentiating HVHM and HCC.

scholarly journals Adrenal Rest Tumor of the Liver Preoperatively Diagnosed as Hepatocellular Carcinoma

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Megumu Enjoji ◽  
Katsuya Sanada ◽  
Ryota Seki ◽  
Takashi Ito ◽  
Masato Maeda
Keyword(s):  
Hepatocellular Carcinoma ◽  
Arterial Phase ◽  
Case Presentation ◽  
Adrenal Rest Tumor ◽  
Histopathologic Diagnosis ◽  
Adrenal Rest ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Delayed Phase ◽  
Microscopic Findings

Background. Hepatic adrenal rest tumors are rare and show similar findings to hepatocellular carcinoma (HCC). It is difficult to distinguish an adrenal rest tumor from HCC due to radiological similarity. We report a case of an adrenal rest tumor in the liver that mimicked HCC radiologically. Case Presentation. A 67-year-old female was referred to our hospital due to the finding of a hepatic mass. Enhanced computed tomography revealed a 17 mm well-defined tumor that was enhanced in the arterial phase and washed out in the portal and delayed phase in the posterosuperior subsegment of the right hepatic lobe, and HCC was suspected. We performed a subsegmental resection of the liver. Microscopic findings showed that the tumor was composed of pale cells, and tumor cells were aligned in alveolar or fascicular arrangements in a similar manner to features of adrenocortical tissue. Immunohistochemically, the tumor expressed synaptophysin and CD56. The final histopathologic diagnosis in this case was an adrenal rest tumor of the liver. Conclusions. An adrenal rest tumor is similar to HCC in radiological findings. This hepatic tumor should be added to the list of radiological differential diagnoses of hypervascular hepatic tumors.

scholarly journals Quantitative Analysis of Hypervascular Hepatic Metastases and Hepatocellular Carcinoma using Spectral CT Imaging

2020 ◽  
Author(s):  
Zhiqiang Yang ◽  
Xinyi Wang ◽  
Hao Shi
Keyword(s):  
Hepatocellular Carcinoma ◽  
Quantitative Analysis ◽  
Spectral Curve ◽  
Iodine Concentration ◽  
Ct Imaging ◽  
Arterial Phase ◽  
Spectral Ct ◽  
Portal Venous Phase ◽  
Significant Difference ◽  
Venous Phase

Abstract Background The goal of this study is to evaluate the performance of spectral CT-based quantitative analysis in differential diagnosis of hypervascular hepatic metastasis (HVHM) and hepatocellular carcinoma (HCC). Methods Spectral CT scans were performed for 47 patients with hepatic malignant tumors, including 20 patients with HVHM and 27 patients with HCC, which generated the following sets of data: single energy images in the arterial phase; iodine and water maps; marginal areas of lesions that manifested apparent signal intensification; and energy spectral parameters of normal liver tissues and abdominal aorta. Subsequently, we calculated the normalized iodine concentrations (NIC), lesion-normal parenchyma iodine concentration ratio (LNR), iodine concentration difference (ICD) between the arterial phase and the venous phase, and the spectral curve slope. An independent samples t test and receiver operating characteristic (ROC) curve analysis were applied to examine these quantitative parameters. Results In the arterial phase, the HVHM and HCC groups displayed no differences in NIC, LNR, or spectral curve slope ( P > 0.05). In the venous phase, the two groups displayed significant differences in NIC, LNR, and spectral curve slope; the NIC was 0.59 ± 0.08 for the HVHM group and 0.4 5 ± 0.10 for the HCC group; the LNR was 1.17 ± 0.22 and 0.92 ± 0.16, respectively; the spectral curve slope was 1.85 ± 0.49 and 1.18 ± 0.34, respectively. In addition, there was no significant difference in ICD between the HVHM group (0.54 ± 0.39 g/L) and HCC group (0.45 ± 0.39 g/L) ( P > 0.05). Finally, there were no significant differences of water or iodine concentration between the arterial phase and venous phase ( P > 0.05). Taken together, the spectral curve slope in the portal venous phase had the best performance in differentiating HVHM from HCC. Conclusions HVHM and HCC have apparent differences in spectral curve and concentrations of radiocontrast agents in the portal venous phase. Hence, spectral CT imaging provides a new multiparameter quantitative approach for differentiating HVHM and HCC.

scholarly journals Can Enhancement Pattern and Enhancement Level on Biphasic Enhanced CT Distinguish Homogeneous Pheochromocytomas From Adenomas Without Lipid

2020 ◽  
Author(s):  
Yongyu An ◽  
Fengjuan Tian ◽  
Bin Lin ◽  
Meihua Shao ◽  
Fangmei Zhu ◽  
...  
Keyword(s):  
Arterial Phase ◽  
Inclusion Criteria ◽  
Enhancement Pattern ◽  
Unenhanced Ct ◽  
Peak Enhancement ◽  
Enhanced Ct ◽  
Cystic Changes ◽  
Venous Phase ◽  
The Mean ◽  
Attenuation Values

Abstract Objective The purpose of our study was to evaluate whether enhancement pattern and enhancement level on biphasic enhanced CT can distinguish homogeneous pheochromocytomas from adenomas without lipid and explore the value of percentage of peak enhancement (PPE) in differentiating the two entities.Methods We retrospectively analysed pathologically proven 17 pheochromocytomas and 34 adenomas. Both tumors were homogeneous without necro-cystic changes and hemorrhage. The inclusion criteria for adenomas without lipid in our study was that the mean attenuation values were greater than 10 HU and the minimum values were greater than 0 HU on unenhanced CT. Biphasic CT scan protocol consisted of unenhanced phase, arterial phase (25-35 seconds) and venous phase (60-80 seconds). The enhancement pattern, attenuation values on unenhanced and enhanced phases and PPE were compared between the two groups.Results Enhancement pattern was similar between the two groups (p>0.99), persistent enhancement pattern on venous phase was the most common in both tumors. The precontrast CT values of pheochromocytomas were significantly higher than that of adenomas without lipid (41 HU vs 37 HU, p=0.006). The enhancement level on arterial and venous phase of pheochromocytomas was greater than that of adenomas without lipid, but no significant differences were found (100 HU vs 85 HU, p=0.223; 103 HU vs 96 HU, p=0.905, respectively). The distribution of PPE of two entities was different. A range of 100%-240% of PPE can discriminate adenomas without lipid from pheochromocytomas, with sensitivity of 88.2%, specificity of 47.1%. Conclusion The enhancement pattern and enhancement level on biphasic enhanced CT could not distinguish homogeneous pheochromocytomas from adenomas without lipid. Further studies are needed to prove the potential value of PPE due to its low specificity.

scholarly journals MDCT angiography in evaluation of pediatric hemangiomas and peripheral vascular malformations

2018 ◽  
Vol 6 (12) ◽  
pp. 4087
Author(s):  
Rohini Gupta Ghasi ◽  
Varun Narayan ◽  
Brij Bhushan Thukral
Keyword(s):  
Soft Tissue Mass ◽  
Vascular Malformations ◽  
Maximum Intensity Projection ◽  
Arterial Phase ◽  
Venous Malformations ◽  
Mdct Angiography ◽  
Tissue Mass ◽  
Peak Enhancement ◽  
Venous Phase ◽  
Delayed Phase

Background: To evaluate the role of MDCT angiography in peripheral hemangiomas and vascular malformations in pediatric patients.Methods: Total of 36 consecutive pediatric patients with clinically suspected peripheral hemangiomas and peripheral malformations were included in the study. MDCT angiography and doppler sonography was done for all patients. Final diagnosis was made by response to treatment and follow up. The statistical significance of various MDCT findings and post processing techniques was calculated. p value of <0.05 was considered significant.Results: Venous malformations were the most common. The MDCTA features which were significant in diagnosing venous malformations were phleboliths (p=0.039), peak enhancement in venous or delayed phase, absence of soft tissue mass, lacy tangle of vessels on maximum intensity projection and volume rendered images. Features significant in diagnosing arteriovenous malformations were tortuous arterial feeders, peak enhancement in arterial phase (0.0001), early draining vein (p=0.0001), venous phase wash out (p=0.0001), tense tangle of vessels on maximum intensity projection and volume rendered images (p=0.0003). Phleboliths (p=0.43) and venous or delayed phase peak enhancement (p=0.69) were overlapping features in congenital hemangiomas and venous malformations. Arterial phase enhancement (p=0.10) and early draining veins (p=0.39) were overlapping features in infantile proliferating hemangiomas and arteriovenous malformations. However, presence of soft tissue mass (p=0.0001) and lack of venous phase wash out (p=0.0003) were differentiating features for hemangiomas.Conclusions: MDCT angiography can be used as a highly accurate modality to diagnose hemangiomas and vascular malformations. It has an advantage over color Doppler in depicting entire extent of deep lesions.

scholarly journals Value of contrast-enhanced CT texture analysis in predicting IDH mutation status of intrahepatic cholangiocarcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yong Zhu ◽  
Yingfan Mao ◽  
Jun Chen ◽  
Yudong Qiu ◽  
Yue Guan ◽  
...  
Keyword(s):  
Texture Analysis ◽  
Ct Images ◽  
Textural Features ◽  
Mutation Status ◽  
Portal Venous Phase ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Venous Phase ◽  
Ct Texture Analysis

AbstractTo explore the value of contrast-enhanced CT texture analysis in predicting isocitrate dehydrogenase (IDH) mutation status of intrahepatic cholangiocarcinomas (ICCs). Institutional review board approved this study. Contrast-enhanced CT images of 138 ICC patients (21 with IDH mutation and 117 without IDH mutation) were retrospectively reviewed. Texture analysis was performed for each lesion and compared between ICCs with and without IDH mutation. All textural features in each phase and combinations of textural features (p < 0.05) by Mann–Whitney U tests were separately used to train multiple support vector machine (SVM) classifiers. The classification generalizability and performance were evaluated using a tenfold cross-validation scheme. Among plain, arterial phase (AP), portal venous phase (VP), equilibrium phase (EP) and Sig classifiers, VP classifier showed the highest accuracy of 0.863 (sensitivity, 0.727; specificity, 0.885), with a mean area under the receiver operating characteristic curve of 0.813 in predicting IDH mutation in validation cohort. Texture features of CT images in portal venous phase could predict IDH mutation status of ICCs with SVM classifier preoperatively.

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