Objective: To describe instances of iodine, or other element with similar K-edge to iodine, accumulating in benign renal cysts and simulating solid renal masses (SRM) at single-phase contrast-enhanced (CE) dual-energy CT (DECT).
Methods: During the course of routine clinical practice, instances of benign renal cysts (reference standard true non-contrast enhanced CT [NCCT] homogeneous attenuation <10 HU and not enhancing, or MRI) simulating SRM at follow-up single-phase CE-DECT due to iodine (or other element) accumulation were documented in two institutions over a 3-month observation period in 2021.
Results: Five Bosniak one renal cysts (12 ± 7 mm) in five patients changed nature on follow-up imaging simulating SRM at CE-DECT. At time of DECT, cyst attenuation on true NCCT (mean 91 ± 25 HU [Range 56-120]) was significantly higher compared to virtual NCCT (mean 11 ± 22 HU [-23-30], = 0.003) and all five cysts showed internal iodine content on DECT iodine maps with concentration >1.9 mg ml (mean 8.2 ± 7.6 mg ml [2.8-20.9]).
Conclusion: The accumulation of iodine, or other element with similar K-edge to iodine, in benign renal cysts could simulate enhancing renal masses at single-phase contrast-enhanced DECT.
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| http://dx.doi.org/10.1259/bjr.20221079 | DOI Listing |
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