Iodine Content Analysis Using Dual-Energy Computed Tomography as a Biomarker of Transitional Cell Carcinoma, an Experience with Separation of the Clotted Blood and Tumorous Tissue.
BACKGROUND/AIM
The aim of this study was to evaluate the possibility to discriminate the blood clot from tumorous tissue in the assessment of transitional cell carcinoma (TCC), when CT data are used only from single-phase dual-energy CT (DECT).


MATERIALS AND METHODS
A total of 18 patients were included into the retrospective analysis of the prospectively collected data (the average age was 67.3 years, range=62-79 years, 12 males, 6 females). DECT was performed in all patients after intravenous administration of the iodinated contrast material. DECT analysis using three-material decomposition algorithm was used to discriminate blood and enhancing tumorous tissue. In all patients, TCC was detected and subsequently kidney surgery or endoscopy was performed within the next two weeks. The findings were compared with DECT results.


RESULTS
In our cohort of patients we found 9 TCC of the renal pelvis or ureter and 7 TCC of the urinary bladder. The accuracy of the TCC detection was 94% (17/18). The presence of coagulated blood within the urinary collecting system together with a tumor was detected in 7 CT examinations. The blood coagulum without a confirmed malignant tumor was found in one case with false positive DECT finding. In other 6 cases bleeding was confirmed during surgery or endoscopy (accuracy 87%).


CONCLUSION
The dual-energy data analysis enables discrimination of a blood clot from tumorous tissue. It helps in detection of UCC in cases when the excretion potential of the kidneys is decreased due to fulfillment of the collecting system with blood clots.
['Mirka|Hynek|H|', 'Baxa|Jan|J|', 'Hora|Milan|M|', 'Hes|Ondrej|O|', 'Topolcan|Ondrej|O|', 'Ferda|Jiri|J|']
D000368:Aged D000465:Algorithms D014408:Biomarkers, Tumor D002295:Carcinoma, Transitional Cell D003287:Contrast Media D005260:Female D006801:Humans D007455:Iodine D007668:Kidney D008297:Male D008875:Middle Aged D012189:Retrospective Studies D013927:Thrombosis D014057:Tomography, X-Ray Computed D001743:Urinary Bladder
Dual-energy CT hematuria transient cell carcinoma urinary tract tumors