Differentiation of Subtypes of Renal Cell Carcinoma on Helical CT Scans

Kim, Jeong Kon; Kim, Tae Kyoung; Ahn, Hyung Taek; Kim, Chung Soo; Kim, Kyu-Rae; Cho, Kyoung-Sik

doi:10.2214/ajr.178.6.1781499

Cited by 366 publications

(225 citation statements)

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“…A potential alternative to increased use of biopsy might lie in the use of diagnostic imaging to characterize renal cortical tumors on the basis of their tissue composition, morphologic features, and/or contrast enhancement patterns (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). Doppler ultrasonography, contrast material-enhanced computed tomography, and magnetic resonance (MR) imaging have shown potential for enabling differentiation of clear cell renal carcinomas (which show increased vascular flow and enhance avidly) from papillary and chromophobe carcinomas (which show reduced vascular flow and less enhancement) (21)(22)(23)(24)(26)(27)(28)).…”

Section: Discussionmentioning

confidence: 99%

“…Doppler ultrasonography, contrast material-enhanced computed tomography, and magnetic resonance (MR) imaging have shown potential for enabling differentiation of clear cell renal carcinomas (which show increased vascular flow and enhance avidly) from papillary and chromophobe carcinomas (which show reduced vascular flow and less enhancement) (21)(22)(23)(24)(26)(27)(28)). Yet despite the encouraging early results, imaging diagnosis and particularly differentiation of benign and malignant histologic subtypes of renal cortical tumors remains problematic, and further studies with multiple independent readers are needed to assess the diagnostic performance of imaging in this clinical context.…”

Section: Discussionmentioning

confidence: 99%

“…In keeping with these changes in clinical management, the role of imaging has also been evolving from detection and staging to better characterization of renal cortical tumors. With the aim of supplementing established imaging criteria based on morphologic features, the vascularity and contrast enhancement features of renal cortical tumors have been investigated for their potential to help identify specific histologic subtypes of these tumors (21)(22)(23)(24)(26)(27)(28)). An analysis by Sun et al (28) of MR images from two postcontrast time points (corticomedullary and nephrographic phases) yielded findings similar to ours; specifically, the analysis found that contrast enhancement was greatest in clear cell carcinomas, intermediate in chromophobe carcinomas, and lowest in papillary carcinomas.…”

Section: Genitourinary Imaging: Renal Cortical Tumorsmentioning

confidence: 99%

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Renal Cortical Tumors: Use of Multiphasic Contrast-enhanced MR Imaging to Differentiate Benign and Malignant Histologic Subtypes

Vargas

Chaim²,

Lefkowitz³

et al. 2012

Radiology

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Purpose:To investigate the use of quantitative multiphasic contrast material-enhanced magnetic resonance (MR) imaging in differentiating between common benign and malignant histologic subtypes of renal cortical tumors. Materials and Methods:The institutional review board waived informed consent and approved this retrospective HIPAA-compliant study of 138 patients who underwent preoperative contrastenhanced MR imaging during the period of January 2004-December 2008. At surgery, 152 renal tumors were identified (77 clear cell, 22 papillary, 18 chromophobe, and 10 unclassified carcinomas; 16 oncocytomas; nine angiomyolipomas). Three readers independently identified and measured the most-enhanced area in each tumor and placed corresponding regions of interest in similar positions on images from the precontrast, corticomedullary, nephrographic, and excretory phases. The percentage change in signal intensity (%SI change) between precontrast imaging and each postcontrast phase was calculated.Interreader agreement was evaluated by using the overall concordance correlation coefficient (OCC). A linear mixed-effects model was used to estimate and compare the trajectories of the means of log %SI change across all phases between the six histologic subtypes. results:Interreader agreement was substantial to almost perfect (OCC, 0.77-0.88). The %SI change differed significantly between clear cell carcinomas and papillary and chromophobe carcinomas in all phases of enhancement (P , .0001-.0120). In addition, %SI change was significantly higher in angiomyolipomas than in clear cell carcinomas, but only in the corticomedullary phase (P = .0231). Enhancement did not differ significantly between clear cell carcinoma and oncocytoma in any phase (P = .2081-.6000). conclusion:Quantitative multiphase contrast-enhanced MR imaging offers a widely available, reproducible method to characterize several histologic subtypes of renal cortical tumors, although it does not aid differentiation between clear cell carcinomas and oncocytomas.q RSNA, 20121 From the Departments of Radiology (H

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Genitourinary Imaging: Renal Cortical Tumorsmentioning

confidence: 99%

See 1 more Smart Citation

Renal Cortical Tumors: Use of Multiphasic Contrast-enhanced MR Imaging to Differentiate Benign and Malignant Histologic Subtypes

Vargas

Chaim²,

Lefkowitz³

et al. 2012

Radiology

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“…Both the attenuation value and degree of enhancement of CDC are similar to papillary and chromophobe renal carcinomas. 5 But because of hemorrhage and necrosis, het- erogeneous or dominantly peripheral enhancement pattern were more common in CT scans, both of which are associated with a poor prognosis. 5 On the other hand, Medullary involvement and an infiltrative appearance are common findings on cross-sectional imaging and may suggest the diagnosis of CDC.…”

Section: Discussionmentioning

confidence: 99%

A case report of collecting duct carcinoma of the kidney coexistent with giant adrenal myelolipoma

Ding

2013

CUAJ

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Collecting duct carcinoma (CDC) of the kidney coexistent with giant adrenal myelolipoma is rare. We report a case of 70-yearold female who presented with a history of gross hematuria and back pain. On investigation, she had a mass in the left kidney and left adrenal gland, respectively. The patient underwent left radical nephrectomy with left adrenalectomy. Pathological findings revealed a renal CDC with partial aquamous metaplasia, in addition to an adrenal myelolipoma. Interleukin-2 was administered for 3 months after operation. Neither signs of recurrence nor metastasis has developed after a 4-year follow-up.

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“…Experienced Radiologist of 7 to 8 years were reviewed for interpretation of images at the PACS section,who is responsible to measure tumor in a particular region with the correlation of Hounsfield unit.Arising of CT imaging technique (Kim et al, 2002) makes the pathologic results as blinded.Quick response is best then the pathology reports.The quantitative and qualitative assessment of tumor lesion is evaluated by the radiologist.The tumor lesion is of ball and bean shaped lesions.The contour detectionof ball shaped renal mass (Dunnick et al, 1992) is superior than the bean shaped lesions.The qualitative assessment of tumor enhancement is determined by visually.The degree of enhancement is vary for the hypo dense (cyst) and hyper dense(carcinoma).Tumor attenuation is the value of Hounsfield unit , where the content of cell present. The strength of tumor cells represents the Hounsfield unit.It is kept as the reference for the imaging and Biopsy.TIME is a measure of success and diagnostic efficacy surely have proven early predictions and documented utility of CT to be true.…”

Section: Analysis Of Ct Imagementioning

confidence: 99%

Feature Extraction by Gray Level Co-occurrence Matrices Parameters in Computed Tomography of Renal Cell Carcinoma

Gomalavalli¹

2017

IJRASET

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I. INTRODUCTIONOver the last 5 decades there has been a growing drift to define small renal cell masses present in the kidney in which the area of interest is not known by anyone. The masses present below 4cm in diameter are any interest of region is the origin of the renal cell carcinoma in world wide.The reason for this task is a different imaging modality has undertaken to investigate the incidence of cell carcinoma. The ultrasound is a screening test and the RCC incidence opinion is highly based on the experienced clinician. Even though there is a lot of problem facing in this incidence, they have given a different opinion to analyze the RCC.Finally; the challenge has taken by an urologist not to suggest the surgical treatment after discussion with the Radiologist. The CT imaging technique gives the clear picturization of the images. The urologist asked the radiologist to give more and more exploration explanation for not only the incidence of RCC but also the clear analysis of mass present in it. The cystic type of fluid mass delineates and differentiates the solid mass of RCC. Bidirectional information is gathered for the RCC incidence in the kidney, between the urologist and Radiologist. There is a parallel reviewing analysis of RCC between them. Initial stage carcinoma can be successfully treated with surgery is more favorable. Later on the advanced stage of renal cell carcinoma prediction leads to critical and failure of Radiotherapy and chemotherapy. Even though before the arrival of imaging techniques, the urologist and the patient are facing lot of problems in diagnosis. Emerging of the imaging modalities in clinical increases the urologist in smiling face. The information explored with the help of CT is high favorable to prognosis and avoid surgery.The protocol of the CT imaging and Biopsy is detailed in figure. 1. The radiologist should provide a high-quality imaging investigation, is very important. The experienced radiologists provide the clear information of RCC with a high quality imaging examination and also exclude the simulator of renal neoplasm. The radiologists should provide important key points during their therapeutic decision-making in their reports:

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Differentiation of Subtypes of Renal Cell Carcinoma on Helical CT Scans

Cited by 366 publications

References 19 publications

Renal Cortical Tumors: Use of Multiphasic Contrast-enhanced MR Imaging to Differentiate Benign and Malignant Histologic Subtypes

Renal Cortical Tumors: Use of Multiphasic Contrast-enhanced MR Imaging to Differentiate Benign and Malignant Histologic Subtypes

A case report of collecting duct carcinoma of the kidney coexistent with giant adrenal myelolipoma

Feature Extraction by Gray Level Co-occurrence Matrices Parameters in Computed Tomography of Renal Cell Carcinoma

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