Tumoral vascular pattern in renal cell carcinoma and fat-poor renal angiomyolipoma as a novel helpful differentiating factor on contrast-enhanced CT scan

Bagheri, Seyed Morteza; Khajehasani, Fatemeh; Fatemi, Iman; Ayoubpour, Mohammad Reza

doi:10.1177/1010428317733144

Cited by 6 publications

(8 citation statements)

References 25 publications

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“…According to previous studies, 21.8-24.5% of RCCs, including non-small RCCs, had perirenal vessels or CVs [11,14]. In our study, CVs were observed in 45.5% (56/123) of RCCs using CECT, but none were observed in fpAMLs.…”

Section: Discussionsupporting

confidence: 58%

“…Studies on organs such as the thyroid gland and uterus have shown that the evaluation of vascular patterns allows for accurate differential diagnosis using ultrasonography [17,18]. Previous studies on renal tumors revealed that evaluating the vascular pattern using CECT permits an accurate differential diagnosis between fpAML and RCC [11,14]. In the study by Bagheri et al [14], peritumor vessels were de ned as those with a diameter of 2 mm or greater.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies on renal tumors revealed that evaluating the vascular pattern using CECT permits an accurate differential diagnosis between fpAML and RCC [11,14]. In the study by Bagheri et al [14], peritumor vessels were de ned as those with a diameter of 2 mm or greater. In the present study, the diameter of the peritumoral vessels was very small because only SRMs were analyzed.…”

Section: Discussionmentioning

confidence: 99%

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Differential Diagnosis and Prognosis of Small Renal Masses: Association with Collateral Vessels Detected Using Contrast-Enhanced Computed Tomography

Yanagi

Kiriyama

Akatsuka

et al. 2022

Preprint

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Background Active surveillance (AS) is one of the treatment methods for patients with small renal masses (SRMs; <4 cm), including renal cell carcinomas (RCCs). However, some small RCCs may exhibit aggressive neoplastic behaviors and metastasize. Little is known about imaging biomarkers capable of identifying potentially aggressive small RCCs. Contrast-enhanced computed tomography (CECT) often detects collateral vessels arising from neoplastic angiogenesis in RCCs. Therefore, this study aimed to evaluate the association between SRM differential diagnoses and prognoses, and the detection of collateral vessels using CECT. Methods A total of 130 consecutive patients with pathologically confirmed non-metastatic SRMs (fat-poor angiomyolipomas [fpAMLs; n = 7] and RCCs [n = 123]) were retrospectively enrolled. Between 2011 and 2019, SRM diagnoses in these patients were confirmed after biopsy or surgical resection. All RCCs were surgically resected. Regardless of diameter, a collateral vessel (CV) was defined as any blood vessel connecting the tumor from around the kidney using CECT. First, we analyzed the role of CV-detection in differentiating between fpAML and RCC. Then, we evaluated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of RCC diagnosis based on CV-detection using CECT. We also assessed the prognostic value of CV-detection using the Fisher exact test, and Kaplan-Meier method and the log-rank test. Results The sensitivity, specificity, PPV, NPV, and accuracy of CV-detection for the diagnosis of small RCCs was 48.5%, 45.5%, 100%, 100%, and 9.5% respectively. Five of 123 (4.1%) patients with RCC experienced recurrence. CV-detection using CECT was the only significant factor associated with recurrence (p = 0.0177). Recurrence-free survival (RFS) was significantly lower in patients with CV compared with in those without CV (5-year RFS 92.4% versus 100%, respectively; p = 0.005). In addition, critical review of the CT images revealed the CVs to be continuous with the venous vessels around the kidney. Conclusions The detection of CVs using CECT is useful for differentiating between small fpAMLs and RCCs. CV-detection may also be applied as a predictive parameter for small RCCs prone to recurrence after surgical resection. Moreover, AS may not be suitable for small RCCs with CVs.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Differential Diagnosis and Prognosis of Small Renal Masses: Association with Collateral Vessels Detected Using Contrast-Enhanced Computed Tomography

Yanagi

Kiriyama

Akatsuka

et al. 2022

Preprint

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“…More than a million people in the United States are annually under emergency investigation due to severe head injuries. 9,10 Most reports concerning these damages are in children less than Five years old and adults over 85 years old.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of sensitivity and the specificity of Canadian CT head rule and New Orleans criteria in patients with head injury

Chobdari¹,

Sharifi²,

Kakhki³

et al. 2018

AMJ

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Background Millions of people around the world are annually under emergency investigation due to severe head injuries. Computed tomography (CT) scans is a diagnostic procedure that can be done for most people. Aims This study is aimed to evaluate the sensitivity and the specificity of Canadian and New Orleans criteria in determining the rate of head injury. Methods To obtain the relationship between clinical symptoms and CT scan results, the required information was obtained by filling out the records and physical examination in the emergency department and the results from the patients were statistically analysed. Data needed to complete the questionnaire was collected from patient, the patient, their

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“…Previously, collateral or perirenal blood vessels were detected in some RCCs using CECT, regardless of CECT protocol. However, these features were not observed in any fpAMLs [11,14]. Accordingly, we hypothesized that collateral vessels (CVs) may be a distinguishing characteristic of RCCs on CECT images.…”

Section: Introductionmentioning

confidence: 94%

Differential diagnosis and prognosis of small renal masses: association with collateral vessels detected using contrast-enhanced computed tomography

et al. 2022

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Background Active surveillance (AS) is one of the treatment methods for patients with small renal masses (SRMs; < 4 cm), including renal cell carcinomas (RCCs). However, some small RCCs may exhibit aggressive neoplastic behaviors and metastasize. Little is known about imaging biomarkers capable of identifying potentially aggressive small RCCs. Contrast-enhanced computed tomography (CECT) often detects collateral vessels arising from neoplastic angiogenesis in RCCs. Therefore, this study aimed to evaluate the association between SRM differential diagnoses and prognoses, and the detection of collateral vessels using CECT. Methods A total of 130 consecutive patients with pathologically confirmed non-metastatic SRMs (fat-poor angiomyolipomas [fpAMLs; n = 7] and RCCs [n = 123]) were retrospectively enrolled. Between 2011 and 2019, SRM diagnoses in these patients were confirmed after biopsy or surgical resection. All RCCs were surgically resected. Regardless of diameter, a collateral vessel (CV) was defined as any blood vessel connecting the tumor from around the kidney using CECT. First, we analyzed the role of CV-detection in differentiating between fpAML and RCC. Then, we evaluated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of RCC diagnosis based on CV-detection using CECT. We also assessed the prognostic value of CV-detection using the Fisher exact test, and Kaplan-Meier method and the log-rank test. Results The sensitivity, specificity, PPV, NPV, and accuracy of CV-detection for the diagnosis of small RCCs was 48.5, 45.5, 100, 100, and 9.5% respectively. Five of 123 (4.1%) patients with RCC experienced recurrence. CV-detection using CECT was the only significant factor associated with recurrence (p = 0.0177). Recurrence-free survival (RFS) was significantly lower in patients with CV compared with in those without CV (5-year RFS 92.4% versus 100%, respectively; p = 0.005). In addition, critical review of the CT images revealed the CVs to be continuous with the venous vessels around the kidney. Conclusions The detection of CVs using CECT is useful for differentiating between small fpAMLs and RCCs. CV-detection may also be applied as a predictive parameter for small RCCs prone to recurrence after surgical resection. Moreover, AS could be suitable for small RCCs without CVs.

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Tumoral vascular pattern in renal cell carcinoma and fat-poor renal angiomyolipoma as a novel helpful differentiating factor on contrast-enhanced CT scan

Cited by 6 publications

References 25 publications

Differential Diagnosis and Prognosis of Small Renal Masses: Association with Collateral Vessels Detected Using Contrast-Enhanced Computed Tomography

Differential Diagnosis and Prognosis of Small Renal Masses: Association with Collateral Vessels Detected Using Contrast-Enhanced Computed Tomography

Evaluation of sensitivity and the specificity of Canadian CT head rule and New Orleans criteria in patients with head injury

Differential diagnosis and prognosis of small renal masses: association with collateral vessels detected using contrast-enhanced computed tomography

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