Systematic review and meta-analysis of preoperative imaging prediction of renal cell carcinoma tumour thrombus inferior vena cava wall invasion

Smith, Ross K.; Navaratnam, Anojan; Vivian, Philip

doi:10.1016/j.crad.2023.02.022

Cited by 6 publications

(4 citation statements)

References 39 publications

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“…However, this study found that FDG PET/CT only exhibited a sensitivity of 62.97% and specificity of 77.77% for TT detection [19]. In a systematic review of 15 pre-operative imaging studies performed by Smith et al, it was concluded that a multi-technique approach-including CT, MRI, and reporting of the vascular radiographic parameter-is necessary to predict IVC wall invasion, thus assisting in surgical planning [20]. It appears that multimodal imaging is essential for surgical planning to effectively determine the appropriate approach for thrombectomy.…”

Section: Advancements In Diagnostic Imaging Of Tumor Thrombusmentioning

confidence: 74%

The Role of Anticoagulation in Tumor Thrombus Associated with Renal Cell Carcinoma: A Literature Review

Williams,

Myint

2023

Cancers

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Tumor thrombus (TT) is a complication of renal cell carcinoma (RCC) for which favorable medical management remains undefined. While radical nephrectomy has been shown to increase overall survival in RCC patients, surgical interventions such as cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) utilized to perform TT resection carry high mortality rates. While it has been documented that RCC with TT is associated with venous thromboembolism (VTE) development, anticoagulation use in these patients remains controversial in clinical practice. Whether anticoagulation is associated with improved survival outcomes remains unclear. Furthermore, if anticoagulation is initiated, there is limited evidence for whether direct oral anticoagulants (DOACs), heparin, or warfarin serve as the most advantageous choice. While the combination of immunotherapy and tyrosine kinase inhibitors (TKIs) has been shown to improve the outcomes of RCC, the clinical benefits of this combination are not well studied prospectively in cases with TT. In this literature review, we explore the challenges of treating RCC-associated TT with special attention to anticoagulation. We provide a comprehensive overview of current surgical and medical approaches and summarize recent studies investigating anticoagulation in RCC patients undergoing surgery, targeted therapy, and/or immunotherapy. Our goal is to provide clinicians with updated clinical insight into anticoagulation for RCC-associated TT patients.

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Section: Advancements In Diagnostic Imaging Of Tumor Thrombusmentioning

confidence: 74%

The Role of Anticoagulation in Tumor Thrombus Associated with Renal Cell Carcinoma: A Literature Review

Williams,

Myint

2023

Cancers

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“…Doppler ultrasonography is being widely used for the detection of RVT among patients who have undergone kidney transplantation, as in this particular category of patients, it has been associated with high sensitivity rates [ 40 , 41 ]. With the advent of 18 FDG PET/CT scan (18 fluorodeoxyglucose positron emission tomography/computed tomography), which is now more widely used, more information about the benign or malignant nature of RVT may be obtained [ 42 , 43 , 44 ]. Due to the fact that RVT may develop in the context of renal cell carcinoma, the metabolic state of the thrombus in renal vein(s) in the PET/CT scan may shed light on whether the origin of the thrombus is benign or not [ 42 , 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…With the advent of 18 FDG PET/CT scan (18 fluorodeoxyglucose positron emission tomography/computed tomography), which is now more widely used, more information about the benign or malignant nature of RVT may be obtained [ 42 , 43 , 44 ]. Due to the fact that RVT may develop in the context of renal cell carcinoma, the metabolic state of the thrombus in renal vein(s) in the PET/CT scan may shed light on whether the origin of the thrombus is benign or not [ 42 , 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Renal Vein Thrombosis Secondary to Pyelonephritis: Targeting a Thrombo-Inflammatory Entity

Kounatidis,

Papadimitropoulos,

Vallianou

et al. 2024

Clinics and Practice

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Renal vein thrombosis (RVT) is a relatively uncommon condition that is most frequently observed in individuals with nephrotic syndrome. While rare, pyelonephritis (PN) may serve as a predisposing factor for secondary RVT. In such cases, one should consider the possibility of RVT when patients fail to respond to appropriate antibiotic treatment. Typically, these patients require additional anticoagulation therapy for a duration of 3 to 6 months, with a generally favorable prognosis. In this report, we present the case of a 74-year-old female who developed RVT due to Klebsiella pneumoniae PN. Additionally, we reviewed 11 cases of PN complicated by RVT, which were documented in the PubMed database over a span of 40 years, emphasizing key elements in diagnostic and therapeutic approaches. Lastly, we elaborated upon the role of thrombo-inflammation, especially in the context of sepsis.

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“…In the neurosurgical community, it is widely acknowledged that meningioma adhesion has major impact on surgical and clinical outcomes. As a result, many studies have examined preoperative MRI findings to predict tumor adhesion [40][41][42][43]. Previous studies have indirectly assessed tumor adhesive tendencies with MRI by measuring tumor vascular distribution and peritumoral cerebrospinal fluid dynamics [28,[44][45][46].…”

Section: Discussionmentioning

confidence: 99%

Improved quantification of tumor adhesion in meningiomas using MR elastography-based slip interface imaging

Zheng,

Murphy,

Camerucci

et al. 2024

PLoS ONE

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Meningiomas, the most prevalent primary benign intracranial tumors, often exhibit complicated levels of adhesion to adjacent normal tissues, significantly influencing resection and causing postoperative complications. Surgery remains the primary therapeutic approach, and when combined with adjuvant radiotherapy, it effectively controls residual tumors and reduces tumor recurrence when complete removal may cause a neurologic deficit. Previous studies have indicated that slip interface imaging (SII) techniques based on MR elastography (MRE) have promise as a method for sensitively determining the presence of tumor-brain adhesion. In this study, we developed and tested an improved algorithm for assessing tumor-brain adhesion, based on recognition of patterns in MRE-derived normalized octahedral shear strain (NOSS) images. The primary goal was to quantify the tumor interfaces at higher risk for adhesion, offering a precise and objective method to assess meningioma adhesions in 52 meningioma patients. We also investigated the predictive value of MRE-assessed tumor adhesion in meningioma recurrence. Our findings highlight the effectiveness of the improved SII technique in distinguishing the adhesion degrees, particularly complete adhesion. Statistical analysis revealed significant differences in adhesion percentages between complete and partial adherent tumors (p = 0.005), and complete and non-adherent tumors (p<0.001). The improved technique demonstrated superior discriminatory ability in identifying tumor adhesion patterns compared to the previously described algorithm, with an AUC of 0.86 vs. 0.72 for distinguishing complete adhesion from others (p = 0.037), and an AUC of 0.72 vs. 0.67 for non-adherent and others. Aggressive tumors exhibiting atypical features showed significantly higher adhesion percentages in recurrence group compared to non-recurrence group (p = 0.042). This study validates the efficacy of the improved SII technique in quantifying meningioma adhesions and demonstrates its potential to affect clinical decision-making. The reliability of the technique, coupled with potential to help predict meningioma recurrence, particularly in aggressive tumor subsets, highlights its promise in guiding treatment strategies.

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Systematic review and meta-analysis of preoperative imaging prediction of renal cell carcinoma tumour thrombus inferior vena cava wall invasion

Cited by 6 publications

References 39 publications

The Role of Anticoagulation in Tumor Thrombus Associated with Renal Cell Carcinoma: A Literature Review

The Role of Anticoagulation in Tumor Thrombus Associated with Renal Cell Carcinoma: A Literature Review

Renal Vein Thrombosis Secondary to Pyelonephritis: Targeting a Thrombo-Inflammatory Entity

Improved quantification of tumor adhesion in meningiomas using MR elastography-based slip interface imaging

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