Characterization of histological subtypes of clear cell renal cell carcinoma using contrast-enhanced ultrasound (CEUS)

Reimann, R.; Rübenthaler, Johannes; Hristova, Petkana; Staehler, Michael; Reiser, Maximilian; Clevert, Dirk-André

doi:10.3233/ch-152009

Cited by 12 publications

(6 citation statements)

References 37 publications

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“…RCC is an abundant blood supply tumor with high density and thin-walled blood vessels, leading to an accelerated circulation of contrast medium and shortening perfusion and clearance. AML is characterized by malformed blood vessels, irregularly thickened walls, and narrow lumens, resulting in the slow circulation of the contrast agent and long perfusion and clearance (17,18,27). Dai et al (28) demonstrated that the peak intensity of a tumor (PI t ) and the time to peak intensity of a tumor (TTP t ) between benign and malignant lesions were both statistically significant (P=0.003.…”

Section: Discussionmentioning

confidence: 99%

“…Lu et al (9) found that both centripetal enhancement in the cortical phase (71.9% vs. 23.2%) and homogeneous peak enhancement (100% vs. 27.5%) were important for differentiating an AML from a ccRCC. Some researchers have reported that ccRCC is mainly characterized by heterogeneous hyperperfusion, while pRCC and chRCC mostly feature homogeneous hypoperfusion (17,18). In our more recent study, it was found that hyperenhancement (64/81, 79.0%), homogeneous enhancement (54/81, 66.7%), fast wash-out (WO) (63/81, 77.8%), and peripheral rim-like enhancement (PRE) (45/81, 55.6%) were the typical features of small RCC (19).…”

Section: Introductionmentioning

confidence: 99%

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The quantitative evaluation of contrast-enhanced ultrasound in the differentiation of small renal cell carcinoma subtypes and angiomyolipoma

Liu¹,

Cao²,

Chen³

et al. 2022

Quant Imaging Med Surg

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Background: Contrast-enhanced ultrasound (CEUS) has been widely used for renal lesion diagnosis and differential diagnosis. However, qualitative analysis of CEUS is subject to examinations with low reproducibility. This study aims to investigate the diagnostic value of CEUS quantitative parameters in differentiating small renal cell carcinoma (RCC) subtypes and angiomyolipoma (AML).Methods: A retrospective analysis was performed on 97 cases of a small renal mass undergoing a CEUS before a radical or partial nephrectomy procedure. A region of interest (ROI) was placed in the tumor's maximum enhanced region (ROI max ) as much as possible, and adjacent renal cortex (ROI refer ) was selected from normal renal tissue around a mass of the same depth. The time-intensity curve (TIC) was used to analyze the ROI max and the ROI refer of the tumors quantitatively. Then the parameters of the ROI max and the ROI refer , including the differences between the parameters of the ROI max and the ROI refer , were analyzed statistically.Results: In RCC and clear cell renal cell carcinoma (ccRCC), the peak intensity (PI), slope (SL), area under the curve (AUC), area under the wash-in curve (AWI), area under the wash-out curve (AWO), time to peak intensity (TTP) and the mean transit time (MTT) were statistically significant between ROI max and ROI refer (all P=0.000). The △PI (△PI = PI max − PI refer ), △SL (△SL = SL max − SL refer ), △AUC (△AUC = AUC max − AUC refer ), △AWI (△AWI = AWI max − AWI refer ) and △AWO (△AWO = AWO max − AWO refer ) of RCC were significantly higher than in AML (P=0.007, 0.000, 0.003, 0.048, 0.009, respectively), while the TTP (△TTP = TTP max − TTP refer ) and △MTT (△MTT = MTT max − MTT refer ) of RCC were significantly lower (both P=0.000). In comparison with papillary renal cell carcinoma (pRCC) and chromophobe renal cell carcinoma (chRCC), the △PI, △SL, △AUC and △AWO of ccRCC were all larger (all P<0.05). The sensitivity, specificity, and AUC of the combination of parameter difference for differentiating RCC from AML were 100%, 81.2%, and 0.965, respectively, and for differentiating ccRCC from pRCC and chRCC, 85.71%, 85.92% and 0.911, respectively.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The quantitative evaluation of contrast-enhanced ultrasound in the differentiation of small renal cell carcinoma subtypes and angiomyolipoma

Liu¹,

Cao²,

Chen³

et al. 2022

Quant Imaging Med Surg

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“…During image fusion, it is still technically possible to use all other image modes of the ultrasound system, such as color Doppler and CEUS. Using all the different image techniques in real time allows comprehensive imaging and characterization of the vascularization of renal lesions [11,21-23]. Lesions that cannot be sufficiently seen on native B-mode ultrasound, for example due to a very deep location of the lesion, sometimes cannot be co-registered with the CT imaging dataset due to the normal limitations of conventional ultrasound.…”

Section: Methodsmentioning

confidence: 99%

Multislice computed tomography/contrast-enhanced ultrasound image fusion as a tool for evaluating unclear renal cysts

2019

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Ultrasonography is a generally accepted imaging technique for diagnosing and monitoring cystic renal lesions. The widely used Bosniak classification (I-IV) categorizes renal cystic lesions into five distinctive groups according to ultrasonography and computed tomography (CT) image criteria. For solid renal lesions, determination of vascularity is discriminatory for malignancy in most instances. In indeterminate cases, contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging/CT-ultrasound image fusion are able to detect and characterize difficult pathologies, with superior performance to either technique alone. In contrast to multislice CT (MS-CT), ultrasound image fusion is a real-time imaging technique that can be used in combination with other cross-sectional imaging modalities. This technical note describes state-of-the-art image fusion of CEUS and MS-CT to detect and characterize unclear renal pathologies.

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“…For instance, ccRCC often shows early inhomogeneous enhancement and rapid regression. The enhancement margin around the lesion described as pseudocapsule is usually apparent in the late stage of regression, which is another characteristic manifestation of diagnostic ccRCC [ 13 ]. Conversely, pRCC usually shows progressive enhancement and persistent low enhancement [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of high frame frequency contrast-enhanced ultrasound in renal tumors

Zhang,

Wang,

Chen

2024

BMC Med Imaging

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Objective This study aims to analyze the characteristics of high frame rate contrast-enhanced ultrasound (H-CEUS) in renal lesions and to improve the ability for differential diagnosis of renal tumors. Methods A total of 140 patients with renal lesions underwent contrast-enhanced ultrasound (CEUS) examination in the First Affiliated Hospital of Nanchang University from July 2022 to July 2023. Based on the tumor pathology and the results of enhanced CT, tumor patients were divided into malignant and benign groups. All subjects were examined using gray-scale ultrasound, conventional contrast-enhanced ultrasound (C-CEUS), and H-CEUS, and their dynamic images were recorded. Two radiologists independently analyzed and recorded the results of ultrasound, C-CEUS, and H-CEUS images and statistically analyzed the features of C-CEUS and H-CEUS images. The independent sample t-test was used to compare the difference in age and maximum diameter of nodules between the benign and malignant groups. The χ2 test was used to compare the sex, mode of operation, gray-scale ultrasound characteristics, and enhancement characteristics of the two CEUS modes (enhancement mode, regression mode, enhancement degree, enhancement uniformity, enhancement or not, enhancement direction, post-enhancement boundary and range, and pseudocapsule) between the benign and malignant groups. The difference in vascular morphology of malignant nodules of varying sizes under two angiographic modes. Results There were significant differences in gender (χ2 = 10.408, P = 0.001), mode of operation (χ2 = 47.089, P < 0.001), nodule composition (χ2 = 7.481, P = 0.003), nodule echo (χ2 = 20.926, P < 0.001), necrosis (χ2 = 31.343, P < 0.001) and nodule blood flow (χ2 = 9.006, P = 0.029) between the benign and malignant groups. There were significant differences in the regression model (χ2 = 6.782, P = 0.034) and enhancement direction (χ2 = 13.771, P = 0.001) between the two radiographic techniques in the malignant group. There was a significant difference in the enhancement uniformity between the two CEUS techniques in the benign group (χ2 = 8.264, P = 0.004). There was a significant difference between the two CEUS techniques in displaying the vascular morphology in the malignant group with the maximum diameter of nodules ≤ 4.0 cm (χ2 = 11.421, P < 0.022). However, there was no significant difference between the two techniques in the malignant group with the maximum diameter of nodules > 4.0 cm. Conclusion Increasing the frame rate of ultrasound images is helpful to accurately display the enhanced features and vascular morphology of renal tumors, especially for malignant tumors with a maximum diameter of ≤ 4.0 cm. Thus, H-CEUS can make up for the limitation of CEUS with regard to the display of vascular morphology.

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Characterization of histological subtypes of clear cell renal cell carcinoma using contrast-enhanced ultrasound (CEUS)

Abstract: Our study suggests that CEUS may be an additional tool for non-invasive characterisation and differentiation of the three histological subtypes of clear cell RCC. Furthermore, it seems to have an additional diagnostic value in daily clinical.

Cited by 12 publications

References 37 publications

The quantitative evaluation of contrast-enhanced ultrasound in the differentiation of small renal cell carcinoma subtypes and angiomyolipoma

The quantitative evaluation of contrast-enhanced ultrasound in the differentiation of small renal cell carcinoma subtypes and angiomyolipoma

Multislice computed tomography/contrast-enhanced ultrasound image fusion as a tool for evaluating unclear renal cysts

Characteristics of high frame frequency contrast-enhanced ultrasound in renal tumors

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