Qualitative and Quantitative Imaging Evaluation of Renal Cell Carcinoma Subtypes with Grating-based X-ray Phase-contrast CT

Abstract

Current clinical imaging methods face limitations in the detection and correct characterization of different subtypes of renal cell carcinoma (RCC), while these are important for therapy and prognosis. The present study evaluates the potential of grating-based X-ray phase-contrast computed tomography (gbPC-CT) for visualization and characterization of human RCC subtypes. The imaging results for 23 ex vivo formalin-fixed human kidney specimens obtained with phase-contrast CT were compared to the results of the absorption-based CT (gbCT), clinical CT and a 3T MRI and validated using histology. Regions of interest were placed on each specimen for quantitative evaluation. Qualitative and quantitative gbPC-CT imaging could significantly discriminate between normal kidney cortex (54 ± 4 HUp) and clear cell (42 ± 10), papillary (43 ± 6) and chromophobe RCCs (39 ± 7), p < 0.05 respectively. The sensitivity for detection of tumor areas was 100%, 50% and 40% for gbPC-CT, gbCT and clinical CT, respectively. RCC architecture like fibrous strands, pseudocapsules, necrosis or hyalinization was depicted clearly in gbPC-CT and was not equally well visualized in gbCT, clinical CT and MRI. The results show that gbPC-CT enables improved discrimination of normal kidney parenchyma and tumorous tissues as well as different soft-tissue components of RCCs without the use of contrast media.

3D virtual histology of murine kidneys –high resolution visualization of pathological alterations by micro computed tomography

“…The similar radio-opaque properties of lead and tungsten are however, a possible drawback of such an experimental set up. An alternative innovative CT based approach using phase contrast has been reported, which enabled the ex vivo depiction of human renal carcinoma specimens without contrast agents, making use of the x-ray phase shift that occurs due to different passing characteristics of matter 25 . We showed that the process of PTA staining preserved the tissue without any shrinkage.…”

Partial versus radical nephrectomy for T1b-2N0M0 renal tumors: A propensity score matching study based on the SEER database

“…Based on the results of our study, the clear-cell RCC patients would potentially receive more therapeutic benefit of PN than RN. Fortunately, with the advance development of imaging technology, current clinical imaging methods are developed in the detection and correct characterization of different RCC subtypes, such as using the Grating-based X-ray Phase-contrast CT[ 21 ], multiphasic multidetector computed tomography (MDCT) scan[ 22 ] and 18F-fluorodeoxyglucose-PETCT[ 23 ].This clinical imaging information may contribute to treatment plan by the urologist.…”

Localized chromophobe renal cell carcinoma: preoperative imaging judgment and laparoscopic simple enucleation for treatment

“…It has been evidenced that multiphasic CT is useful for distinguishing the benign vs. malignant renal masses and discriminating the pathological subtypes of RCC ( 20 , 21 ). In the study, chRCC tends to be homogenous, solid, well circumcised and without calcification.…”

“…In the study, chRCC tends to be homogenous, solid, well circumcised and without calcification. Braunagel M, et al ( 21 ) compared the CT imaging which features different subtypes of renal cell carcinoma (RCC), it was concluded that chRCCs were the most homogeneous tumors with fibrous strands and microbleeding without detection of hyalinization or necrosis. According to Zhang J's study ( 22 ), heterogeneous renal lesions were more likely to behaving aggressively.…”