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BioMed Research International
Volume 2014 (2014), Article ID 135013, 10 pages
Clinical Study

CT Perfusion in the Characterisation of Renal Lesions: An Added Value to Multiphasic CT

1Department of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Viale Bracci 10, 53100 Siena, Italy
2Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Viale Bracci 10, 53100 Siena, Italy
3Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy
4Department of Medical Biotechnologies, Section of Pathology, University of Siena, Viale Bracci 10, 53100 Siena, Italy
5Department of Medical, Surgical and Neuro Sciences, Section of Pathology, University of Siena, Viale Bracci 10, 53100 Siena, Italy

Received 25 April 2014; Accepted 16 June 2014; Published 13 August 2014

Academic Editor: Lorenzo Preda

Copyright © 2014 Francesco Giuseppe Mazzei et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To prospectively evaluate if computed tomography perfusion (CTp) could be a useful tool in addition to multiphasic CT in renal lesion characterisation. Materials and Methods. Fifty-eight patients that were scheduled for surgical resection of a renal mass with a suspicion of renal cell carcinoma (RCC) were enrolled. Forty-one out of 58 patients underwent total or partial nephrectomy after CTp examination, and a pathological analysis was obtained for a total of 49 renal lesions. Perfusion parameters and attenuation values at multiphasic CT for both lesion and normal cortex were analysed. All the results were compared with the histological data obtained following surgery. Results. PS and MTT values were significantly lower in malignant lesions than in the normal cortex ( and , resp.); PS, MTT, and BF values were also statistically different between oncocytomas and malignant lesions. According to ROC analysis, the accuracy, sensitivity, and specificity to predict RCC were 95.92%, 100%, and 66.7%, respectively, for CTp whereas they were 89.80%, 93.35%, and 50%, respectively, for multiphasic CT. Conclusion. A significant difference between renal cortex and tumour CTp parameter values may suggest a malignant renal lesion. CTp could represent an added value to multiphasic CT in differentiating renal cells carcinoma from oncocytoma.