Abstract
OBJECTIVES: To validate the "overflowing beer sign" (OBS) for distinguishing between lipid-poor angiomyolipoma (AML) and renal cell carcinoma, and to determine whether it improves the detection of lipid-poor AML when added to the angular interface sign, a previously-validated morphologic feature associated with AML.
METHODS: Retrospective nested case-control study of all 134 AMLs in an institutional renal mass database matched 1:2 with 268 malignant renal masses from the same database. Cross-sectional imaging from each mass was reviewed and the presence of each sign was identified. A random selection of 60 masses (30 AML and 30 benign) was used to measure interobserver agreement.
RESULTS: Both signs were strongly associated with AML in the total population (OBS: OR 17.4 95% CI 8.0-42.5, p < 0.001; angular interface: OR 12.6, 95% CI 5.9-29.7, p < 0.001) and the population of patients excluding those with visible macroscopic fat (OBS: OR 11.2, 95% CI 4.8-28.7, p < 0.001; angular interface: 8.5, 95% CI 3.7-21.1, p < 0.001). In the lipid-poor population, the specificity of both signs was excellent (OBS: 95.6%, 95% CI 91.9%-98%; angular interface: 95.1%, 95% CI 91.3%-97.6%). Sensitivity was low for both signs (OBS: 31.4%, 95% CI 24.0-45.4%; angular interface: 30.5%, 95% CI 20.8%-41.6%). Both signs showed high levels of inter-rater agreement (OBS 90.0% 95% CI 80.5 - 95.9; angular interface 88.6, 95% CI 78.7-94.9) Testing for AML using the presence of either sign in this population improved sensitivity (39.0%, 95% CI 28.4%-50.4%, p = 0.023) without significantly reducing specificity (94.2%, 95% CI 90%-97%, p = 0.2) relative to the angular interface sign alone.
CONCLUSIONS: Recognition of the OBS increases the sensitivity of detection of lipid-poor AML without significantly reducing specificity.
Original language | English |
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Pages (from-to) | 208.e9-208.e14 |
Journal | Urologic Oncology: Seminars and Original Investigations |
Volume | 41 |
Issue number | 4 |
DOIs | |
State | Published - Apr 2023 |
Keywords
- Angiomyolipoma
- Magnetic resonance imaging
- Renal cell carcinomas
- X-ray computed tomography
- Kidney Neoplasms/diagnosis
- Diagnosis, Differential
- Humans
- Angiomyolipoma/diagnosis
- Lipids
- Case-Control Studies
- Carcinoma, Renal Cell/diagnosis
- Sensitivity and Specificity
- Retrospective Studies
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Dive into the research topics of 'Distinguishing lipid-poor angiomyolipoma from renal carcinoma using tumor shape'. Together they form a unique fingerprint.Press/Media
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Researchers at Fox Chase Cancer Center Release New Data on Kidney Cancer (Distinguishing Lipid-poor Angiomyolipoma From Renal Carcinoma Using Tumor Shape)
07/18/23
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Biostatistics and Bioinformatics Facility
Ross, PhD, ScM, E. A. (Director), Devarajan, PhD, K. (Staff), Zhou, PhD, Y. (Staff), Zhou, MSE, PhD, Y. (Staff), Egleston, PhD, MPP, B. (Staff), Hasler, PhD, J. S. (Staff) & Zhang, PhD, L. (Staff)
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