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Fig. 2A. —46-year-old woman with papillary renal cell carcinoma (arrow). Unenhanced (A), vascular phase (B), and nephrographic phase (C) CT scans. Region of interest circles were drawn on observer-estimated areas of highest and lowest densities on contrast-enhanced scans (B and C) to determine tumor heterogeneity. During vascular phase, tumor enhancement is 22 H compared with aortic enhancement of 232 H, giving a 0.1 heterogeneity ratio.