T1a renal cell carcinoma on unenhanced CT: analysis of detectability and imaging features

Background Increasing use of unenhanced computed tomography (CT) has been associated with the increasing incidental detection of renal cell carcinoma (RCC) at an earlier stage. Purpose To evaluate the characteristics in detecting and differentiating T1a RCCs on unenhanced CT. Material and Methods We retrospectively reviewed 68 patients with 68 T1a RCCs and 39 benign regions. Two radiologists interpreted the images on unenhanced axial CT and performed a blinded and independent review of T1a RCCs. The readers evaluated the presence of RCC and differentiated the detected lesions. Results The consensus of two readers detected 53 (78%) RCCs. Of the 53 detected RCCs, 42 (62%) RCCs were correctly diagnosed and 11 (16%) masses were misdiagnosed as benign. Of the 39 benign regions, 29 (74%) cysts were diagnosed correctly, but 10 (26%) cysts were misdiagnosed as malignant. The following values of the radiologists were obtained by consensus: sensitivity = 61.8% (42/68); specificity = 74.4% (29/39); positive predictive value = 80.8% (42/52); negative predictive value = 55.0% (29/55); accuracy = 66.4% (71/107). The receiver operating characteristic curve of consensus was 0.754. Inter-observer correlation was κ = 0.849. There was a significant difference in tumor size ( P = 0.019) and the contour type of tumor ( P = 0.0207) between correctly diagnosed RCCs and not correctly diagnosed RCCs. Conclusion Our findings showed that tumor size and contour type could affect the detection and differentiation of T1a RCC on unenhanced CT. To detect and differentiate T1a RCC on unenhanced CT is difficult. However, the findings from this study may help detection of RCCs on unenhanced CT.

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Comparative study of CT and MRI appearances in mucinous tubular and spindle cell carcinoma and papillary renal cell carcinoma

British Journal of Radiology ◽

10.1259/bjr.20210548 ◽

2021 ◽

pp. 20210548

Author(s):

Dajun lu ◽

Weibiao Yuan ◽

Qingqiang Zhu ◽

Jing Ye ◽

Wenrong Zhu ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Spindle Cell ◽

Papillary Renal Cell Carcinoma ◽

Spindle Cell Carcinoma ◽

Ct Imaging ◽

Imaging Features ◽

Unenhanced Ct ◽

Ct And Mri

Objective: To explore the feasibility of CT and MRI in differentiating mucinous tubular and spindle cell carcinoma (MTSCC) and papillary renal cell carcinoma (PRCC). Methods: 23 patients with MTSCC and 38 patients with PRCC were studied retrospectively. CT and MRI were undertaken to investigate differences in tumour characteristics. Results: 23 patients with MTSCC and 38 patients with PRCC (included 15 cases Type 1,and 23 cases Type 2), tumours (mean diameter 3.7 ± 1.6 cm vs 4.6 ± 1.7 cm, p < 0.05), cystic components (5 vs 32, p < 0.01), calcifications (3 vs 11, p > 0.05), haemorrhage (1 vs 22, p < 0.01), tumour boundaries (1 vs 37, p < 0.01), and homogeneous enhancement (20 vs 11, p < 0.01). The density of MTSCC was lower than that of PRCC, normal renal cortex (p < 0.05), except for the medulla(p > 0.05). MTSCC and PRCC tumour enhancement were lower than that for normal cortex and medulla during all enhanced phases (p < 0.05). Enhancement was higher with PRCC than with MTSCC tumours during all phases (p < 0.05). On MRI, nine cases of MTSCC and 19 cases of PRCC, tumour showed homogeneous (9 vs 3, p < 0.01), heterogeneous (0 vs 16, p < 0.01), hyperintense on T1WI (0 vs 15, p < 0.01), slightly hyperintense on T2WI (9 vs 1, p < 0.01), hypointense on T2WI (0 vs 15, p < 0.05) , relatively high signal intensity was seen on DWI (9 vs 15, p > 0.05), respectively. Conclusion: CT imaging features of MTSCC include isodense or hypodense mass on unenhanced CT, with unclear boundaries; however, PRCC showed mild hyperdensity, easily have cystic components. The degree enhancement of MTSCC is lower than that for PRCC. On MR, MTSCC was slightly hyperintense on T2WI, whereas PRCC was hypointense. Advances in knowledge: 1.CT imaging features of MTSCC include isodense or hypodense mass on unenhanced CT, with unclear boundaries. 2. CT imaging features of PRCC include mild hyperdensity on unenhanced CT, easily have cystic components. 3. On enhanced CT, the degree enhancement of MTSCC is lower than that for PRCC. On MR, MTSCC was slightly hyperintense on T2WI whereas PRCC was heterogeneously hypointense on T2WI.

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Unenhanced CT for the detection of renal cell carcinoma: effect of tumor size and contour type

Abdominal Imaging ◽

10.1007/s00261-013-0068-7 ◽

2014 ◽

Vol 39 (2) ◽

pp. 348-357 ◽

Cited By ~ 3

Author(s):

Sung Il Jung ◽

Hee Sun Park ◽

Young Jun Kim ◽

Hae Jeong Jeon

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Tumor Size ◽

Renal Cell ◽

Unenhanced Ct

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Correlation of CT imaging features and tumor size with Fuhrman grade of clear cell renal cell carcinoma

Acta Radiologica ◽

10.1177/0284185116649795 ◽

2016 ◽

Vol 58 (3) ◽

pp. 376-384 ◽

Cited By ~ 17

Author(s):

Saelin Oh ◽

Deuk Jae Sung ◽

Kyung Sook Yang ◽

Ki Choon Sim ◽

Na Yeon Han ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Roc Curve ◽

Tumor Size ◽

Renal Cell ◽

Clear Cell ◽

Ct Imaging ◽

Imaging Features ◽

Cell Renal Cell Carcinoma ◽

Fuhrman Grade

Background Identification of clinical features to determine the aggressive potential of tumors is highly warranted to stratify patients for adequate treatment. Computed tomography (CT) imaging features of clear cell renal cell carcinoma (ccRCC) may contribute to personalized risk assessment. Purpose To assess the correlation between CT imaging features and Fuhrman grade of ccRCC, and to identify the predictors of high Fuhrman grade in conjunction with tumor size. Material and Methods CT scans of 169 patients with 173 pathologically proven ccRCCs were retrospectively reviewed in consensus by two radiologists for the presence of intratumoral necrosis and intratumoral cyst and tumor size. Histologic grade was classified as either low (Fuhrman grade I or II) or high (Fuhrman grade III or IV). Statistical significance was evaluated by using univariate, multivariate regression, receiver operating characteristic (ROC) curve, and Spearman correlation analyses. Results On CT, 20 of the 173 tumors had intratumoral cysts, 60 had intratumoral necrosis, and 93 showed entirely solid tumors. The odds of high grade were higher with intratumoral necrosis and entirely solid tumor than with intratumoral cyst ( P < 0.03). Intratumoral necrosis showed a significantly high odds ratio of 25.73 for high Fuhrman grade. The ROC curve showed a threshold tumor size of 36 mm to predict high Fuhrman grade for overall tumors (area under the ROC curve, 0.70). In ccRCCs with intratumoral necrosis or cyst, tumor size did not significantly correlate with Fuhrman grade. Conclusion Intratumoral necrosis on CT was a strong and independent predictor of biologically aggressive ccRCCs, irrespective of tumor size.

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A CT-Based Radiomics Approach for the Differential Diagnosis of Sarcomatoid and Clear Cell Renal Cell Carcinoma

BioMed Research International ◽

10.1155/2020/7103647 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Xiaoli Meng ◽

Jun Shu ◽

Yuwei Xia ◽

Ruwu Yang

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Characteristic Curve ◽

Univariate Analysis ◽

Image Features ◽

Regression Method ◽

Cell Renal Cell Carcinoma ◽

Significant Difference

This study was aimed at building a computed tomography- (CT-) based radiomics approach for the differentiation of sarcomatoid renal cell carcinoma (SRCC) and clear cell renal cell carcinoma (CCRCC). It involved 29 SRCC and 99 CCRCC patient cases, and to each case, 1029 features were collected from each of the corticomedullary phase (CMP) and nephrographic phase (NP) image. Then, features were selected by using the least absolute shrinkage and selection operator regression method and the selected features of the two phases were explored to build three radiomics approaches for SRCC and CCRCC classification. Meanwhile, subjective CT findings were filtered by univariate analysis to construct a radiomics model and further selected by Akaike information criterion for integrating with the selected image features to build the fifth model. Finally, the radiomics models utilized the multivariate logistic regression method for classification and the performance was assessed with receiver operating characteristic curve (ROC) and DeLong test. The radiomics models based on the CMP, the NP, the CMP and NP, the subjective findings, and the combined features achieved the AUC (area under the curve) value of 0.772, 0.938, 0.966, 0.792, and 0.974, respectively. Significant difference was found in AUC values between each of the CMP radiomics model (0.0001≤p≤0.0051) and the subjective findings model (0.0006≤p≤0.0079) and each of the NP radiomics model, the CMP and NP radiomics model, and the combined model. Sarcomatoid change is a common pathway of dedifferentiation likely occurring in all subtypes of renal cell carcinoma, and the CT-based radiomics approaches in this study show the potential for SRCC from CCRCC differentiation.

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Diagnostic Accuracy of Unenhanced CT Analysis to Differentiate Low-Grade From High-Grade Chromophobe Renal Cell Carcinoma

American Journal of Roentgenology ◽

10.2214/ajr.17.18874 ◽

2018 ◽

Vol 210 (5) ◽

pp. 1079-1087 ◽

Cited By ~ 23

Author(s):

Nicola Schieda ◽

Robert S. Lim ◽

Satheesh Krishna ◽

Matthew D. F. McInnes ◽

Trevor A. Flood ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Diagnostic Accuracy ◽

Cell Carcinoma ◽

Renal Cell ◽

Chromophobe Renal Cell Carcinoma ◽

Low Grade ◽

High Grade ◽

Unenhanced Ct ◽

Ct Analysis

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Prognostic Value of Plasma hPG80 (Circulating Progastrin) in Metastatic Renal Cell Carcinoma

Cancers ◽

10.3390/cancers13030375 ◽

2021 ◽

Vol 13 (3) ◽

pp. 375

Author(s):

Manish Kohli ◽

Winston Tan ◽

Bérengère Vire ◽

Pierre Liaud ◽

Mélina Blairvacq ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Prognostic Value ◽

Risk Model ◽

Predictive Accuracy ◽

Area Under The Curve ◽

Risk Groups ◽

Prognostic Impact ◽

Significant Difference

Precise management of kidney cancer requires the identification of prognostic factors. hPG80 (circulating progastrin) is a tumor promoting peptide present in the blood of patients with various cancers, including renal cell carcinoma (RCC). In this study, we evaluated the prognostic value of plasma hPG80 in 143 prospectively collected patients with metastatic RCC (mRCC). The prognostic impact of hPG80 levels on overall survival (OS) in mRCC patients after controlling for hPG80 levels in non-cancer age matched controls was determined and compared to the International Metastatic Database Consortium (IMDC) risk model (good, intermediate, poor). ROC curves were used to evaluate the diagnostic accuracy of hPG80 using the area under the curve (AUC). Our results showed that plasma hPG80 was detected in 94% of mRCC patients. hPG80 levels displayed high predictive accuracy with an AUC of 0.93 and 0.84 when compared to 18–25 year old controls and 50–80 year old controls, respectively. mRCC patients with high hPG80 levels (>4.5 pM) had significantly lower OS compared to patients with low hPG80 levels (<4.5 pM) (12 versus 31.2 months, respectively; p = 0.0031). Adding hPG80 levels (score of 1 for patients having hPG80 levels > 4.5 pM) to the six variables of the IMDC risk model showed a greater and significant difference in OS between the newly defined good-, intermediate- and poor-risk groups (p = 0.0003 compared to p = 0.0076). Finally, when patients with IMDC intermediate-risk group were further divided into two groups based on hPG80 levels within these subgroups, increased OS were observed in patients with low hPG80 levels (<4.5 pM). In conclusion, our data suggest that hPG80 could be used for prognosticating survival in mRCC alone or integrated to the IMDC score (by adding a variable to the IMDC score or by substratifying the IMDC risk groups), be a prognostic biomarker in mRCC patients.

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