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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1446801

Determinants of Conventional and Contrast-Enhanced Ultrasound Diagnosis of Fat-Poor Angiomyolipoma <5 cm

Provisionally accepted
Xia Liang Xia Liang Xian-Tao Zeng Xian-Tao Zeng Zhi-Liang Hong Zhi-Liang Hong Miao-Jiao Su Miao-Jiao Su Jian-Chuan Yang Jian-Chuan Yang Song Song Wu Song Song Wu *
  • Fujian Provincial Hospital, Fuzhou, China

The final, formatted version of the article will be published soon.

    Purpose: This study aims to assess the diagnostic efficacy of conventional ultrasound (CUS) and contrast-enhanced ultrasound (CEUS) in detecting fat-poor angiomyolipomas(AML) with dimensions less than 5 cm. Additionally, the study seeks to identify independent indicators for predicting the presence of fat-poor AML. Methods: We conducted a retrospective analysis of patients diagnosed with renal AML and renal cell carcinoma, who were admitted and underwent surgery at Fujian Provincial Hospital from January 2013 to October 2023. A total of 154 renal tumors were included (104 renal cell carcinomas and 50 fat-poor AMLs). Prior to radical or partial nephrectomy, these patients underwent both CUS and CEUS examinations. We systematically analyzed the features observed in CUS and CEUS, identified independent factors through multifactorial regression analysis, and evaluated diagnostic efficacy by calculating the area under the curve (AUC). Results: Univariate analysis revealed significant distinctions in fat-poor AML concerning gender, age, morphology, internal hyperechoic features (starry-sky sign, crescent sign), enhancement uniformity, and delayed enhancement, all displaying significance compared to renal cell carcinoma (RCC) (p < 0.05). Multivariate analysis demonstrated that internal hyperechoic features (p < 0.01, Odds Ratio [OR] = 0.003, 95% Confidence Interval [CI]: 0.000-0.0028) and enhancement uniformity (p < 0.01, OR = 0.016, 95% CI: 0.001-0.229) independently predicted fat-poor AML. The Receiver Operating Characteristic (ROC) curve's area under the curve (AUC) for internal hyperechoic features (starry-sky sign, crescent sign) was 0.88 (95% CI: 0.80–0.95), with a sensitivity of 78.00%, specificity of 97.12%, positive predictive value of 92.85%, and negative predictive value of 90.18%. Conversely, the ROC curve AUC for enhancement uniformity was 0.70 (95% CI: 0.62–0.78), with a sensitivity of 96.00%, specificity of 44.23%, positive predictive value of 45.28%, and negative predictive value of 95.83%. Conclusion: This study suggests that both CUS and CEUS possess discriminative value in differentiating fat-poor AMLs from RCCs. Notably, internal hyperechoic features (starry-sky sign, crescent sign) and uniform enhancement within renal tumors emerge as potential independent indicators for predicting fat-poor AML. Keywords：fat-poor angiomyolipoma, renal cell carcinoma, contrast-enhanced ultrasound, conventional ultrasound, starry-sky sign, crescent sign

    Keywords: Fat-poor angiomyolipoma, Renal cell carcinoma, contrast-enhanced ultrasound, Conventional Ultrasound, starry-sky sign

    Received: 10 Jun 2024; Accepted: 14 Nov 2024.

    Copyright: © 2024 Liang, Zeng, Hong, Su, Yang and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Song Song Wu, Fujian Provincial Hospital, Fuzhou, China

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