Imaging Tool for Predicting Renal Clear Cell Carcinoma Fuhrman Grade: Comparing R.E.N.A.L. Nephrometry Score and CT Texture Analysis

Background. Clear cell renal cell carcinoma (ccRCC) is the most common renal malignant tumor. Preoperative imaging boasts advantages in diagnosing and choosing treatment methods for ccRCC. Purpose. This study is aimed at building models based on R.E.N.A.L. nephrometry score (RNS) and CT texture analysis (CTTA) to estimate the Fuhrman grade of ccRCC and comparing the advantages and disadvantages of the two models. Materials and Methods. 143 patients with pathologically confirmed ccRCC were enrolled. All patients were stratified into Fuhrman low-grade and high-grade groups with complete CT data and R.E.N.A.L. nephrometry scores. CTTA features were extracted from the ROI delineated at the largest tumor level, and RNS and CTTA features were included in the logistic regression model, respectively. Results. RNS model constructed based on multivariate logistic regression analysis showed that 3 pts for R -scores, 2 pts for E -scores, and 3 pts for L -scores were significant indicators to predict high-grade ccRCC, the AUC of RNS model was 0.911, and the sensitivity and specificity were 71.11% and 83.67%, respectively. The CTTA-model confirmed energy, kurtosis, and entropy as independent predictive factors, and the AUC of CTTA model was 0.941, with an optimal sensitivity and specificity of 84.44% and 93.88%. Conclusions. R.E.N.A.L. nephrometry score has a certain provocative effect on the Fuhrman pathological grading of ccRCC. As a potential emerging technology, CTTA is expected to replace R.E.N.A.L. nephrometry score in evaluating patients’ Fuhrman classification, and this approach might become an available method for assisting clinicians in choosing appropriate operation.

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CT texture analysis in the differentiation of major renal cell carcinoma subtypes and correlation with Fuhrman grade

European Radiology ◽

10.1007/s00330-019-06260-2 ◽

2019 ◽

Vol 29 (12) ◽

pp. 6922-6929 ◽

Cited By ~ 17

Author(s):

Yu Deng ◽

Erik Soule ◽

Aster Samuel ◽

Sakhi Shah ◽

Enming Cui ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Texture Analysis ◽

Renal Cell ◽

Fuhrman Grade ◽

Ct Texture Analysis

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Radiogenomics in Clear Cell Renal Cell Carcinoma: Machine Learning–Based High-Dimensional Quantitative CT Texture Analysis in PredictingPBRM1Mutation Status

American Journal of Roentgenology ◽

10.2214/ajr.18.20443 ◽

2019 ◽

Vol 212 (3) ◽

pp. W55-W63 ◽

Cited By ~ 26

Author(s):

Burak Kocak ◽

Emine Sebnem Durmaz ◽

Ece Ates ◽

Melis Baykara Ulusan

Keyword(s):

Machine Learning ◽

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Texture Analysis ◽

Renal Cell ◽

Clear Cell ◽

High Dimensional ◽

Quantitative Ct ◽

Cell Renal Cell Carcinoma ◽

Ct Texture Analysis

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CT texture analysis: a potential tool for predicting the Fuhrman grade of clear-cell renal carcinoma

Cancer Imaging ◽

10.1186/s40644-019-0195-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 16

Author(s):

Zhan Feng ◽

Qijun Shen ◽

Ying Li ◽

Zhengyu Hu

Keyword(s):

Texture Analysis ◽

Renal Carcinoma ◽

Clear Cell ◽

Clear Cell Renal Carcinoma ◽

Fuhrman Grade ◽

Cell Renal Carcinoma ◽

Ct Texture Analysis ◽

Potential Tool

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CT texture analysis: a potential tool for prediction of survival in patients with metastatic clear cell carcinoma treated with sunitinib

Cancer Imaging ◽

10.1186/s40644-017-0106-8 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 41

Author(s):

Masoom A. Haider ◽

Alireza Vosough ◽

Farzad Khalvati ◽

Alexander Kiss ◽

Balaji Ganeshan ◽

...

Keyword(s):

Cell Carcinoma ◽

Texture Analysis ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Prediction Of Survival ◽

Ct Texture Analysis ◽

Potential Tool

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Accuracy of CT texture analysis for differentiating low-grade and high-grade renal cell carcinoma: systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-051470 ◽

2021 ◽

Vol 11 (12) ◽

pp. e051470

Author(s):

Wei Yu ◽

Gao Liang ◽

Lichuan Zeng ◽

Yang Yang ◽

Yinghua Wu

Keyword(s):

Systematic Review ◽

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Texture Analysis ◽

Renal Cell ◽

Meta Analysis ◽

Low Grade ◽

High Grade ◽

Ct Texture Analysis ◽

Sensitivity Specificity

ObjectivesThis study aimed to assess the accuracy of CT texture analysis (CTTA) for differentiating low-grade and high-grade renal cell carcinoma (RCC).DesignSystematic review and meta-analysis.Data sourcesPubMed, Cochrane Library, Embase, Web of Science, OVID Medline, Science Direct and Springer were searched to identify the included studies.Eligibility criteria for including studiesClinical studies that report about the accuracy of CTTA in differentiating low-grade and high-grade RCC.MethodsMultiple databases were searched to identify studies from their inception to 20 October 2021. Two radiologists independently extracted data from the primary studies. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic OR (DOR) were calculated to assess CTTA performance. The summary receiver operating characteristic (SROC) curve was plotted, and the area under the curve (AUC) was calculated to evaluate the accuracy of CTTA in grading RCC.ResultsThis meta-analysis included 11 studies, with 1603 lesions observed in 1601 patients. Values of the pooled sensitivity, specificity, PLR, NLR, DOR were 0.79 (95% CI 0.73 to 0.84), 0.84 (95% CI 0.81 to 0.87), 5.1 (95% CI 4.0 to 6.4), 0.24 (95% CI 0.19 to 0.32) and 21 (95% CI 13 to 33), respectively. The SROC curve showed that the AUC was 0.88 (95% CI 0.84 to 0.90). Deeks’ test found no significant publication bias among the studies (p=0.42).ConclusionsThe findings of this meta-analysis suggest that CTTA has a high accuracy in differentiating low-grade and high-grade RCC. A standardised methodology and large sample-based study are necessary to certain the diagnostic accuracy of CTTA in RCC grading for clinical decision making.

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Two Cases of Sporadic Eosinophilic Solid and Cystic Renal Cell Carcinoma in Manitoba Population

International Journal of Surgical Pathology ◽

10.1177/1066896921993229 ◽

2021 ◽

pp. 106689692199322

Author(s):

Seyed Mohammad Mohaghegh Poor ◽

Shivani Mathur ◽

Karl Kassier ◽

Janetta Rossouw ◽

Robert Wightman ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Preoperative Imaging ◽

Renal Neoplasm ◽

Renal Masses ◽

Cystic Renal Cell Carcinoma ◽

Eosinophilic Cytoplasm ◽

Clear Cell Rcc

Two sporadic cases of eosinophilic solid and cystic renal cell carcinoma (ESC RCC), at our institution, are presented in this study to contribute to the growing literature on this novel renal neoplasm. The first patient was a 38-year-old female with two synchronous renal masses measuring 3.5 and 1.9 cm on preoperative imaging. The second patient was a 44-year-old female with an incidental renal mass measuring 4 cm. Both patients underwent uncomplicated radical nephrectomies. The 1.9 cm mass in the first patient was consistent with clear cell RCC. The dominant mass in the first patient and the tumor in the second patient had microscopic and macroscopic findings in keeping with ESC RCC including a tan appearance, abundant eosinophilic cytoplasm, and CK20+ and CK7− staining. Both patients had an uncomplicated course following surgery with no evidence of local recurrence or distant metastatic disease for 1 and 2 years for the first and second patient accordingly. These cases contribute to a growing body of literature regarding ESC RCC including, to our knowledge, the first reported case of synchronous ESC RCC and clear cell RCC. Further research about this novel renal neoplasm is needed.

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Nuclear and cytosolic pS727-STAT3 levels correlate with overall survival of patients affected by clear cell renal cell carcinoma (ccRCC)

Scientific Reports ◽

10.1038/s41598-021-86218-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jazmine Arévalo ◽

David Lorente ◽

Enrique Trilla ◽

María Teresa Salcedo ◽

Juan Morote ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Overall Survival ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Cell Renal Cell Carcinoma ◽

Independent Manner ◽

Fuhrman Grade ◽

Transcription 3 ◽

Aggressive Subtype

AbstractClear cell renal cell carcinoma (ccRCC) is the most frequent and aggressive subtype of renal carcinoma. So far, the basis of its oncogenesis remains unclear resulting in a deficiency of usable and reliable biomarkers for its clinical management. Previously, we showed that nuclear expression of the signal transducer and activator of transcription 3 (STAT3), phosphorylated at its serine 727 (pS727), was inversely proportional to the overall survival of ccRCC patients. Therefore, in the present study, we validated the value of pS727-STAT3 as a clinically relevant biomarker in ccRCC. This work is a retrospective study on 82 ccRCC patients treated with nephrectomy and followed-up for 10 years. Immunohistochemical expression of pS727-STAT3 was analyzed on a tissue microarray and nuclear and cytosolic levels were correlated with clinical outcome of patients. Our results showed that pS727-STAT3 levels, whether in the nucleus (p = 0.002; 95% CI 1.004–1.026) or the cytosol (p = 0.040; 95% CI 1.003–1.042), significantly correlate with patients’ survival in an independent-manner of clinicopathological features (Fuhrman grade, risk group, and tumor size). Moreover, we report that patients with high pS727-STAT3 levels who undergone adjuvant therapy exhibited a significant stabilization of the disease (~ 20 months), indicating that pS727-STAT3 can pinpoint a subset of patients susceptible to respond well to treatment. In summary, we demonstrated that high pS727-STAT3 levels (regardless of their cellular location) correlate with low overall survival of ccRCC patients, and we suggested the use of pS727-STAT3 as a prognostic biomarker to select patients for adjuvant treatment to increase their survival.

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