scholarly journals Effect of Spectral CT on Tumor Microvascular Angiogenesis in Renal Cell Carcinoma

2021 ◽  
Author(s):  
Bei Zhang ◽  
Qiong Wu ◽  
Xiang Qiu ◽  
Xiaobo Ding ◽  
Jin Wang ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Tumor Angiogenesis ◽  
Renal Cell ◽  
Rank Correlation ◽  
Correlation Coefficients ◽  
Spectral Ct ◽  
Spearman Rank Correlation ◽  
Spearman Rank ◽  
The Mean

Abstract Background: To examine the value of spectral CT quantitative parameters in renal cell carcinoma (RCC) microvascular angiogenesis.Methods: The authors evaluated 32 patients with pathologically confirmed RCC who underwent triple-phase contrast-enhanced CT with spectral CT imaging mode from January 2017 to December 2019. Quantitative parameters including the parameters derived from iodine concentration (IC) and water concentration (WC) of 120 keV monochromatic images. The microvascular density (MVD), microvascular area (MVA) and etc. al. of specimens were evaluated. The correlation between IC and WC (including average values and random values) with microvascular parameters were analyzed using Pearson or Spearman rank correlation coefficients.Results: The MVD of all tumors was 26.00 (15.00-43.75) vessels per field at ×400 magnification. The MVD of RCC correlated positively with the mean IC, mean WC, mean NWC, mean NIC, random IC, random NIC in renal cortical phase, WCD1, WCD2, NWCD2 and ICD1 (Spearman rank correlation coefficients, r range, 0.362–0.533; all p < 0.05). The MVA of all tumors was (16.16±8.98) % per field at ×400 magnification. The MVA of RCC correlated positively with the mean IC, mean WC, mean NWC, mean NIC, random IC, random NIC in renal cortical, mean WC and mean NWC in renal parenchymal phase, WCD1, WCD2, WCD3, NWCD2, and NWCD3 (Pearson or Spearman rank correlation coefficients, r range, 0.357–0.576; all p < 0.05). Microvascular grading correlated positively with the mean NWC, mean NIC and random NIC in renal cortical phase, mean NWC in renal parenchymal phase, NWCD2, WCD3, NWCD3, NICD2 and NICD3 (Spearman rank correlation coefficients, r range, 0.367–0.520; all p < 0.05). As for tumor diameter (55.19±19.15), μm, only NWCD3 was associated with it (Spearman rank correlation coefficients, r = 0.388; p < 0.05). Conclusions: IC and WC indexes derived from spectral CT, especially the renal cortical phase, difference between renal cortical phase and parenchymal phase were useful indicators for evaluating tumor angiogenesis. Moreover, the difference of the derived parameters of WC in different phases has stronger correlation with tumor angiogenesis than that of IC.

scholarly journals Effect of spectral CT on tumor microvascular angiogenesis in renal cell carcinoma

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bei Zhang ◽  
Qiong Wu ◽  
Xiang Qiu ◽  
Xiaobo Ding ◽  
Jin Wang ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Rank Correlation ◽  
Correlation Coefficients ◽  
Spectral Ct ◽  
Spearman Rank Correlation ◽  
Spearman Rank ◽  
Quantitative Parameters ◽  
The Mean

Abstract Background To examine the value of energetic-spectrum computed tomography (spectral CT) quantitative parameters in renal cell carcinoma (RCC) microvascular angiogenesis. Methods The authors evaluated 32 patients with pathologically confirmed RCC who underwent triple-phase contrast-enhanced CT with spectral CT imaging mode from January 2017 to December 2019. Quantitative parameters include parameters derived from iodine concentration (IC) and water concentration (WC) of 120 keV monochromatic images. All specimens were evaluated including the microvascular density (MVD), microvascular area (MVA) and so on. The correlation between IC and WC (including average values and random values) with microvascular parameters were analyzed with Pearson or Spearman rank correlation coefficients. Results The MVD of all tumors was 26.00 (15.00–43.75) vessels per field at × 400 magnification. The MVD of RCC correlated positively with the mean IC, mean WC, mean NWC, mean NIC, random IC, random NIC in renal cortical phase, WCD1, WCD2, NWCD2 and ICD1 (Spearman rank correlation coefficients, r range, 0.362–0.533; all p < 0.05). The MVA of all tumors was (16.16 ± 8.98) % per field at × 400 magnification. The MVA of RCC correlated positively with the mean IC, mean WC, mean NWC, mean NIC, random IC, random NIC in renal cortical, mean WC and mean NWC in renal parenchymal phase, WCD1, WCD2, WCD3, NWCD2, and NWCD3 (Pearson or Spearman rank correlation coefficients, r range, 0.357–0.576; all p < 0.05). Microvascular grading correlated positively with the mean NWC, mean NIC and random NIC in renal cortical phase, mean NWC in renal parenchymal phase, NWCD2, WCD3, NWCD3, NICD2 and NICD3 (Spearman rank correlation coefficients, r range, 0.367–0.520; all p < 0.05). As for tumor diameter (55.19 ± 19.15), μm, only NWCD3 was associated with it (Spearman rank correlation coefficients, r = 0.388; p < 0.05). Conclusions ICD and WCD of spectral CT have a potential for evaluating RCC microvascular angiogenesis. MVD, MVA and microvascular grade showed moderate positive correlation with ICD and WCD. ICD displayed more relevant than that of WCD. The parameters of renal cortical phase were the best in three phases. NICD and NWCD manifested stronger correlation with microvascular parameters than that of ICD and WCD.

scholarly journals Quantitative 3-tesla multiparametric MRI in differentiation between renal cell carcinoma subtypes

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ali Elsorougy ◽  
Hashim Farg ◽  
Dalia Bayoumi ◽  
Mohamed Abou El-Ghar ◽  
Magda Shady
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Multiparametric Mri ◽  
Histopathological Analysis ◽  
Adc Value ◽  
Intensity Index ◽  
Apparent Diffusion ◽  
The Mean

Abstract Background MRI provides several distinct quantitative parameters that may better differentiate renal cell carcinoma (RCC) subtypes. The purpose of the study is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC), chemical shift signal intensity index (SII), and contrast enhancement in differentiation between different subtypes of renal cell carcinoma. Results There were 63 RCC as regard surgical histopathological analysis: 43 clear cell (ccRCC), 12 papillary (pRCC), and 8 chromophobe (cbRCC). The mean ADC ratio for ccRCC (0.75 ± 0.13) was significantly higher than that of pRCC (0.46 ± 0.12, P < 0.001) and cbRCC (0.41 ± 0.15, P < 0.001). The mean ADC value for ccRCC (1.56 ± 0.27 × 10−3 mm2/s) was significantly higher than that of pRCC (0.96 ± 0.25 × 10−3 mm2/s, P < 0.001) and cbRCC (0.89 ± 0.29 × 10−3 mm2/s, P < 0.001). The mean SII of pRCC (1.49 ± 0.04) was significantly higher than that of ccRCC (0.93 ± 0.01, P < 0.001) and cbRCC (1.01 ± 0.16, P < 0.001). The ccRCC absolute corticomedullary enhancement (196.7 ± 81.6) was significantly greater than that of cbRCC (177.8 ± 77.7, P < 0.001) and pRCC (164.3 ± 84.6, P < 0.001). Conclusion Our study demonstrated that multiparametric MRI is able to afford some quantitative features such as ADC ratio, SII, and absolute corticomedullary enhancement which can be used to accurately distinguish different subtypes of renal cell carcinoma.

Comparison of General Anesthesia and Conscious Sedation during Computed Tomography–Guided Radiofrequency Ablation of T1a Renal Cell Carcinoma

2018 ◽  
Vol 69 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Hae Jin Kim ◽  
Byung Kwan Park ◽  
In Sun Chung
Keyword(s):  
Renal Cell Carcinoma ◽  
Radiofrequency Ablation ◽  
General Anesthesia ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Conscious Sedation ◽  
Tumour Progression ◽  
Tumour Size ◽  
General Anesthesia Group ◽  
The Mean

Purpose Percutaneous radiofrequency ablation is so painful that this treatment requires pain control such as conscious sedation or general anesthesia. It is still unclear which type of anesthesia is better for treatment outcomes of renal cell carcinoma. This study aimed to compare general anesthesia and conscious sedation in treating patients with renal cell carcinoma with radiofrequency ablation. Methods Between 2010 and 2015, 51 patients with biopsy-proven renal cell carcinomas (<4 cm) were treated with computed tomography–guided radiofrequency ablation. General anesthesia was performed in 41 and conscious sedation was performed in 10 patients. Tumour size, local tumour progression, metastasis, major complication, effective dose, glomerular filtration rate difference, and recurrence-free survival rate were compared between these groups. Results The mean tumour size was 2.1 cm in both groups ( P = .673). Local tumour progression occurred in 0% (0 of 41) of the general anesthesia group, but in 40% (4 of 10) of the conscious sedation group ( P = .001). Metastases in these groups occurred in 2.4% (1 of 41) of the general anesthesia group and 20% (2 of 10) of the conscious sedation group ( P = .094). No major complications developed in either group after the first radiofrequency ablation session. The mean effective doses in these groups were 21.7 mSv and 21.2 mSv, respectively ( P = .868). The mean glomerular filtration rate differences in the general anesthesia and conscious sedation groups were −13.5 mL/min/1.73 m2 and −19.1 mL/min/1.73 m2, respectively ( P = .575). Three-year recurrence-free survival rates in these groups were 97.6% and 60.0%, respectively ( P = .001). Conclusions General anesthesia may provide better intermediate outcomes than conscious sedation in treating small renal cell carcinomas with radiofrequency ablation.

scholarly journals Adrenal metastases: clinical manifestations and surgical outcomes

2018 ◽  
Vol 14 (2) ◽  
pp. 79-87 ◽  
Author(s):  
V. R. Latypov ◽  
O. S. Popov ◽  
V. N. Latypova ◽  
M. Yu. Grishchenko
Keyword(s):  
Lung Cancer ◽  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Tumor Size ◽  
Renal Cell ◽  
Clinical Manifestations ◽  
Adrenal Metastasis ◽  
Adrenal Metastases ◽  
The Mean ◽  
Mean Time

Background. The adrenal glands are one of the most common sites of metastases in malignant disease, particularly lung cancer. The frequency of adrenal metastasis in patients with breast cancer and lung cancer reaches 39 and 35 % respectively.Materials and methods. A total of 156 patients with adrenal tumors underwent surgical treatment in the Siberian State Medical University between December 1998 and July 2017. The study included 16 (10.2 %) patients (9 males and 7 females) with adrenal metastases. The mean age of study participants was 57.6 years (range: 44–73 years).Results. By the moment of surgery, the mean metastatic adrenal tumor size was 4.9 ± 3.0 cm (range: 1.0–10.2 cm). Thirteen out of 16 patients had adrenal metastases from renal cell carcinoma, one patient – from colon cancer, one patient – from lung cancer, and one patient – from breast cancer. Nine patients had left-sided adrenal metastases, whereas six patients had right-sided adrenal metastases. Synchronous adrenal metastasis was detected in two cases: one patient had adrenal metastasis at the side of the renal tumor; the other one had bilateral renal cell carcinoma with both adrenal glands affected.We identified three main variants of the disease course according to prevailing clinical manifestations of adrenal metastasis: no manifestations, pain syndrome, and arterial hypertension.Seven participants had no clinical manifestations; of them, 6 patients had renal cell carcinoma, whereas 1 patient had breast cancer. The mean time between surgical removal of the primary tumor and detection of adrenal metastases was 24.1 months; the mean tumor size was 4.5 cm.Pain syndrome was observed in 5 patients. In three of them, adrenal metastases derived from renal cell carcinoma, in one patient – from lung cancer, and in one patient – from colon cancer. The mean time between removal of the primary tumor and detection of adrenal metastases was 19.8 months; the mean tumor size was 5.4 cm.Arterial hypertension was diagnosed in four patients. The mean time between removal of the primary tumor and identification of adrenal metastases was 27.3 months; the mean tumor size was 4.1 cm. The five-year overall survival rate in operated patient was 47.8 %.Conclusion. Regular examinations of patients after surgical treatment of malignant tumors are needed to detect adrenal metastases; surgery can extend the patient’s life. can extend the patient’s life.

Difference of seasonal variation between glycated albumin and glycated haemoglobin

2018 ◽  
Vol 55 (5) ◽  
pp. 583-587 ◽  
Author(s):  
Karin Tanaka ◽  
Shu Meguro ◽  
Masami Tanaka ◽  
Junichiro Irie ◽  
Yoshifumi Saisho ◽  
...  
Keyword(s):  
Seasonal Variation ◽  
Plasma Glucose ◽  
Seasonal Variations ◽  
Glycated Albumin ◽  
Rank Correlation ◽  
Correlation Coefficients ◽  
Glycated Haemoglobin ◽  
Spearman Rank Correlation ◽  
Spearman Rank ◽  
Average Temperature

Background Glycated albumin reflects 2–3-week glycaemic controls, and in addition to glycated haemoglobin, it has been used as a glycaemic control indicator. We presumed that glycated albumin also has seasonal variations and is related to temperature, similar to glycated haemoglobin. Methods The subjects were diabetic outpatients from April 2007 to March 2013. This resulted in the enrolment of 2246 subjects and the collection of a total of 53,968 measurements. Mean glycated haemoglobin, glycated albumin, and plasma glucose were calculated for each month over six years. The associations of the measures with each other and the average temperature for each month in Tokyo were assessed using Spearman rank correlation coefficients. Results Plasma glucose was highest in January and lowest in May. Glycated haemoglobin was highest in March and lowest in September. Glycated albumin was highest in May and lowest in December. Glycated albumin tended to have a disjunction with plasma glucose in winter. Glycated haemoglobin had seasonal variation, but glycated albumin did not. Plasma glucose and glycated haemoglobin showed significant negative correlations with temperature (rs = −0.359, P < 0.001, rs = −0.449, P < 0.001, respectively), but glycated albumin did not. However, glycated albumin was inter-correlated with plasma glucose (rs = 0.396, P < 0.001) and glycated haemoglobin (rs = 0.685, P < 0.001), and glycated haemoglobin was inter-correlated with plasma glucose (rs = 0.465, P < 0.001). Conclusion Glycated albumin and glycated haemoglobin showed different seasonal variations from each other over the six-year study period. Thus, further studies to identify factors that contribute to glycated albumin are needed.

scholarly journals OSSMAR: An Observational Study to Describe the Use of Sunitinib in Real-Life Practice for the Treatment of Metastatic Renal Cell Carcinoma

2019 ◽  
pp. 1-10 ◽  
Author(s):  
Marwan Ghosn ◽  
Roland Eid ◽  
Emad Hamada ◽  
Hamdy Abdel Azim ◽  
Jamal Zekri ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Clinical Practice ◽  
Middle East ◽  
Adverse Events ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Real Life ◽  
Routine Clinical Practice ◽  
The Mean

PURPOSE Sunitinib offers improved efficacy for patients with metastatic renal cell carcinoma (mRCC). To provide better disease management in the Middle East, we studied its use in mRCC in real-life practice in this region. MATERIAL AND METHODS Patients diagnosed with mRCC and started on sunitinib between 2006 and 2016 from 10 centers in Africa and the Middle East region were studied in this regional, multicenter, observational, retrospective trial to obtain routine clinical practice data on the usage patterns and outcomes of sunitinib in mRCC in real-life practice. RESULTS A total of 289 patients were enrolled. Median age at diagnosis was 58.7 years. The patient characteristics were as follows: 73.6% of patients were males; 85.8% had clear-cell renal cell carcinoma (RCC); 97.5% had unilateral RCC; 66.3% had metastatic disease at initial diagnosis; 56.3% received previous treatment for RCC, among which 98.7% had undergone surgery; and 15.2% and 31.4% were classified in the favorable and poor-risk groups (expanded Memorial Sloan Kettering Cancer Center criteria), respectively. On treatment initiation, the mean total sunitinib dose was 48.1 mg, and 87.6% of patients were started on a sunitinib dose of 50 mg. The mean duration of sunitinib treatment was 9.6 months. Overall response rate was 20.8%, with a median duration of 8.2 months. Median time to progression was 5.7 months. Median follow-up time was 7.8 months. By months 12 and 24, 34.3% and 11.4% of patients, respectively, were still alive. Seventy-six patients (60.9%) experienced 314 adverse events. Twenty-three patients (8.0%) experienced 28 serious adverse events. Overall, 83 patients (28.7%) discontinued their sunitinib treatment. CONCLUSION The results are indicative of the general treatment outcomes of patients with mRCC in the Middle East using sunitinib in routine clinical practice. Reported adverse events are similar to those described in the literature but at lower frequencies.

scholarly journals YAP Promotes VEGFA Expression and Tumor Angiogenesis Though Gli2 in Human Renal Cell Carcinoma

2019 ◽  
Vol 50 (4) ◽  
pp. 225-233 ◽  
Author(s):  
Shan Xu ◽  
Haibao Zhang ◽  
Yue Chong ◽  
Bing Guan ◽  
Peng Guo
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Tumor Angiogenesis ◽  
Renal Cell ◽  
Human Renal Cell Carcinoma

CYBERKNIFE FOR BRAIN METASTASES OF MALIGNANT MELANOMA AND RENAL CELL CARCINOMA

Neurosurgery ◽  
2009 ◽  
Vol 64 (suppl_2) ◽  
pp. A26-A32 ◽  
Author(s):  
Wendy Hara ◽  
Phuoc Tran ◽  
Gordon Li ◽  
Zheng Su ◽  
Putipun Puataweepong ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Malignant Melanoma ◽  
Brain Metastases ◽  
Cell Carcinoma ◽  
Local Control ◽  
Renal Cell ◽  
Systemic Disease ◽  
Karnofsky Performance Scale ◽  
Actuarial Survival ◽  
The Mean

Abstract OBJECTIVE To evaluate the efficacy of CyberKnife (Accuray, Inc., Sunnyvale, CA) stereotactic radiosurgery (SRS) for patients with brain metastases of malignant melanoma and renal cell carcinoma. METHODS We conducted a retrospective review of all patients treated by image-guided radiosurgery at our institution between March 1999 and December 2005. Sixty-two patients with 145 brain metastases of renal cell carcinoma or melanoma were identified. RESULTS The median follow-up period was 10.5 months. Forty-four patients had malignant melanoma, and 18 patients had renal cell carcinoma. The median age was 57 years, and patients were classified as recursive partitioning analysis Class 1 (6 patients), 2 (52 patients) or 3 (4 patients). Thirty-three patients had been treated systemically with either chemotherapy or immunotherapy, and 33 patients were taking corticosteroids at the time of treatment. The mean tumor volume was 1.47 mL (range, 0.02–35.7 mL), and the mean prescribed dose was 20 Gy (range, 14–24 Gy). The median survival after SRS was 8.3 months. Actuarial survival at 6 and 12 months was 57 and 37%, respectively. On multivariate analysis, Karnofsky Performance Scale score (P &lt; 0.01) and previous immunotherapy/clinical trial (P = 0.01) significantly affected overall survival. One-year intracranial progression-free survival was 38%, and local control was 87%. Intracranial control was impacted by whole-brain radiotherapy (P = 0.01), previous chemotherapy (P = 0.01), and control of the primary at the time of SRS (P = 0.02). Surgical resection had no effect on intracranial or local control. Radiographic evidence of radiation necrosis developed in 4 patients (6%). CONCLUSION CyberKnife radiosurgery provided excellent local control with acceptable toxicity in patients with melanoma or renal cell brain metastases. Initial SRS alone appeared to be a reasonable option, as survival was dictated by systemic disease.

The value of PET-CT (positron emission tomography) in the treatment of metastatic renal cell carcinoma with sorafenib

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15621-15621 ◽  
Author(s):  
U. Stierner ◽  
M. Boijsen ◽  
M. Suurküla ◽  
S. Lundstam
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Glucose Uptake ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Initial Value ◽  
Pet Ct ◽  
The Mean ◽  
Mean Glucose ◽  
Skeletal Lesions

15621 Background: Sorafenib is a new potent multikinase inhibitor directed against both tumour proliferation and angiogenesis. Clinical benefit has been shown in 75% of patients with metastatic renal cell carcinoma. The aim of this study was to evaluate this new treatment with PET-CT with fluorodeoxyglucose (FDG), since the use of only CT measurements has been questioned. Methods: 10 patients (8 male, 2 female, 49–72 years) with metastatic renal cell carcinoma (9 clear cell, 1 chromophobe). All had progressive disease (8 after interferon). Sorafenib 400 mg b.i.d was given orally. FDG-PET-CT scan was performed from head-proximal thigh before treatment and after one month. Up to 6 target lesions in each patient were studied. The sum of the largest diameters was calculated from CT images for each patient. To evaluate the glucose uptake, a region of interest (roi) was designed for each leasion on the initial PET on the transverse section where the lesion appeared to be largest and/or most intense. Using the same roi for subsequent examinations the mean glucose uptake/mean cerebellar uptake was calculated. For each patient the mean change from baseline was calculated. Results: After one month of treatment the sum of tumour diameters measured by CT was mean 85% (53–110%) of the initial value. Measured by PET the mean glucose uptake at one month was mean 73% (29–100%) of the initial value. Seven patients had skeletal lesions. These were often difficult to measure on CT and only small changes were detected. Using PET the mean uptake in skeletal lesions was 77% (62–104%) at one month. Conclusions: Early effects of sorafenib treatment in metastatic renal cell carcinoma can be detected and quantified by PET-CT. Especially in skeletal lesions PET-CT exhibits considerable benefits over CT by visualizing responses otherwise missed. Future studies will reveal if a decrease in tumour glucose uptake at one month correlates with the more clinically relevant endpoints PFS and OS. [Table: see text]

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