Association Between Preoperative Hounsfield Unit of Renal Mass and Surgical Margin Status of Partial Nephrectomy

Abstract

Objective: This study aimed to investigate whether preoperative Hounsfield unit (HU) values of renal mass measured on contrast-enhanced computed tomography (CECT) are associated with positive surgical margins (PSM) in patients undergoing partial nephrectomy.

Methods: A retrospective analysis was conducted on 35 patients who underwent laparoscopic partial nephrectomy for renal masses between 2016 and 2022. Hounsfield unit values were obtained by averaging measurements across 3 post-contrast phases of CECT. Surgical margin status and histopathological features were collected from pathology reports. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to evaluate the relationship between HU and PSM.

Results: The mean age of the patients was 55.1 ± 11.9 years, and 71.4% were male. The overall PSM rate was 22.9%. The mean HU value was significantly lower in the PSM group compared to patients with negative surgical margins (58.1 ± 22.9 vs. 85.7 ± 26.4; P = .010). Logistic regression analysis identified HU as an independent predictor of PSM (P = .005). Receiver-operating characteristic analysis revealed a threshold of 40 HU, which predicted PSM with 87.5% sensitivity and 87.5% specificity (area under the curve = 0.58).

Conclusion: Lower HU values on preoperative CECT are significantly associated with PSM in partial nephrectomy. Hounsfield unit may serve as a simple, non-invasive predictor to support surgical planning. Prospective multicenter studies are required to validate these findings.

Cite this article as: İlki FY, Ebiloğlu T, Buyantemur MS, Coğuplugil AE, Topçu YK, Bedir S. Association between preoperative Hounsfield Unit of renal mass and surgical margin status of partial nephrectomy. Cerrahpaşa Med J. 2026; 50: 0062. doi: 10.5152/cjm.2026.25062.