scholarly journals Diagnostic Accuracy of MDCT (Multidetector Computed Tomography) for Staging of Renal Cell Carcinoma

2021 ◽  
Vol 15 (7) ◽  
pp. 1471-1474
Author(s):  
Sadaf Gill ◽  
Sarah Nisar ◽  
Lubna Sarfraz ◽  
Khaula Sidra ◽  
Arshad Faheem ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Ct Scan ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Multidetector Ct ◽  
False Negative ◽  
Radiology Department ◽  
True Negative ◽  
Cross Sectional

Background: The advancement in technology has introduced multi-detector CT scanners and achievement of better spatial resolution with faster acquisition has become a possibility. The three-dimensional reformatted images along with multiplanar reconstructions upgrade the staging capabilities for RCC. Aim: To check accuracy of MDCT (Multi-detector Computed tomography) in staging renal cell carcinoma with histopathology taken as the gold standard. Study design: The study is a descriptive cross sectional study. Settings: Radiology Department, Bahawal Victoria Hospital, Bahawalpur Study duration: 16"' January 2019 to 15"' July 2019. Methods 157 patients (including both genders) were included with age range of 25-60 years, showing features of renal cell carcinoma on ultrasonography. Those Patients with renal mass other than renal cell carcinoma, solitary functioning kidney and pregnant females were eliminated from the study. All the selected patients had Multi-detector CT scan abdomen performed. Results: Mean age was 44.66+9.3 I years. Out of these 157 patients, there were 90(57.32) male patients and 67 (42.68°/c) females with ratio of I.3: I. All the patients had CT scan of abdomen and pelvis. The results showed that 8I of the patients were True Positive and only 08 were False Positive. Out of 68 CT negative patients, 07 (False Negative) showed renal cell carcinoma on histopathology while 6 I True Negative patients had no evidence of RCC on histopathology (p=0.0001). Conclusion: Multi-detector CT scan is a very sensitive yet accurate non - invasive method for staging renal cell ca. Keywords: Renal cell carcinoma, multidetector CT scan, imaging, sensitivity

scholarly journals Correlation between radiological and histopathological findings in patients undergoing nephrectomy for presumed renal cell carcinoma on computed tomography scan at Grey’s Hospital

2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Nompumelelo E. Mlambo ◽  
Nondumiso N.M. Dlamini ◽  
Ronald J. Urry
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Ct Scan ◽  
Cell Carcinoma ◽  
South African ◽  
Renal Cell ◽  
Vascular Invasion ◽  
Retrospective Chart Review ◽  
Renal Masses ◽  
Cross Sectional

Background: The incidence of renal cell carcinoma (RCC) is increasing globally owing to the increased use of cross-sectional imaging. Computed tomography (CT) scan is the modality of choice in the diagnosis and pre-operative assessment of RCC. Nephrectomy is the standard treatment for RCC and pre-surgery biopsy is not routinely practised. The accuracy of CT diagnosis and staging in a South African population has not been established.Objectives: To determine the accuracy of CT scan in the diagnosis and pre-operative staging of RCC at Grey’s Hospital.Methods: A retrospective chart review was performed; CT scan reports and histopathological results of adult patients who underwent nephrectomy for presumed RCC on CT scan between January 2010 and December 2016 were compared.Results: Fifty patients met the inclusion criteria for the study. CT significantly overestimated the size of renal masses by 0.7 cm (p = 0.045) on average. The positive predictive value of CT for RCC was 81%. Cystic tumours and those 4 cm and smaller were more likely to be benign. CT demonstrated good specificity for extra-renal extension, vascular invasion and lymph node involvement, but poor sensitivity.Conclusion: In our South African study population, CT is accurate at diagnosing RCC, but false-positives do occur. Non-enhancing or poorly enhancing, cystic, fat-containing and small lesions (4 cm or smaller) are more likely to be benign and ultrasound-guided biopsy should be considered to avoid unnecessary surgery. CT assessment of extra-renal extension and vascular invasion is challenging and additional imaging modalities such as magnetic resonance imaging (MRI) venogram, duplex Doppler ultrasound or Positron emission tomography–computed tomography (PET/CT) may be beneficial.

Preoperative differentiation of chromophobe renal cell carcinoma from oncocytoma: Aorta-lesion-attenuation difference on multiphasic multidetector computed tomography.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 627-627
Author(s):  
Melina Hosseiny ◽  
Justin Ching ◽  
Soheil Kooraki ◽  
Steven Raman
Keyword(s):  
Renal Cell Carcinoma ◽  
Ct Scan ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Mass ◽  
Multidetector Ct ◽  
Hounsfield Unit ◽  
Chromophobe Renal Cell Carcinoma ◽  
Imaging Biomarker ◽  
The Difference

627 Background: Differentiation of benign oncocytoma from chromophobe renal cell carcinoma (chRCC) remains a challenge. This study aimed to investigate whether Aorta-lesion-attenuation difference (ALAD) on multiphasic multidetector CT scan (MDCT) can aid to distinguish oncocytoma from chRCC. Methods: This IRB-approved, HIPAA-compliant study consisted MDCT of 111 patients with pathologically proven chRCC (N: 37) or oncocytoma (N: 74). Regions of interest (ROIs) were placed over the renal mass and Aorta on the same axial MDCT slice of un-enhanced (UE), corticomedullary (CM), nephrographic (NP) and excretory (EX) phases. ROIs were devoid of calcification, necrosis and hemorrhage in lesion or atherosclerotic plaque in Aorta. The difference between Aorta and renal mass Hounsfield unit was calculated in all available phases. SPSS v.18 was used to draw receiver-operating characteristic (ROC) curve to calculate accuracy and optimal cutoff values for differentiation of chRCC from oncocytoma. Results: Mean ALAD was significantly higher in chRCC compared to oncocytoma in CM(P: 0.04), NP (P<0.01) and EX (P<0.01) phases. The area under the curves for ALAD in UE, CM, NP and EX phases were 0.47 (95% CI: 0.36- 0.59, p: 0.68), 0.64 (95% CI: 0.51-0.77, p: 0.03), 0.87 (95% CI: 0.79- 0.95, p< 0.01) and 0.80 (0.70-0.90, P<0.001), respectively. ALAD threshold of 19 in nephrographic phase had sensitivity and specificity of 79% and 78%, respectively, for differentiation of chRCC from oncocytoma. Conclusions: ALAD measured in the nephrogenic phase showed the highest accuracy for differentiation of chRCC from oncocytoma on multidetector CT scan. If validated prospectively, ALAD may act as a useful imaging biomarker to distinguish chRCC from oncocytoma.

scholarly journals Detection of a peritumoral pseudocapsule in patients with renal cell carcinoma undergoing robot-assisted partial nephrectomy using enhanced MDCT

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Makoto Toguchi ◽  
Toshio Takagi ◽  
Yuko Ogawa ◽  
Satoru Morita ◽  
Kazuhiko Yoshida ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Renal Cell ◽  
Clear Cell ◽  
Robot Assisted ◽  
High Attenuation ◽  
Papillary Rcc ◽  
Clear Cell Rcc

AbstractTo investigate the detection of peritumoral pseudocapsule (PC) using multi-detector row computed tomography (MDCT) for tumors resected by robot-assisted laparoscopic partial nephrectomy (RAPN) for T1 renal cell carcinoma (RCC). Study participants included 206 patients with clinical T1 RCC who underwent RAPN between October 2017 and February 2018. Two radiologists who were blinded to the pathological findings evaluated the computed tomography (CT) images. Radiological diagnosis of a PC was defined by a combination of observations, including a low-attenuation rim between the tumor and renal cortex in the cortico-medullary phase and a high-attenuation rim at the edge of the tumor in the nephrogenic or excretory phase. A PC was detected on CT in 156/206 tumors (76%) and identified by pathology in 182/206 (88%) tumors including 153/166 (92%) clear cell RCC, 13/14 (93%) papillary RCC, and 7/16 (44%) chromophobe RCC. In the whole cohort, CT findings showed a sensitivity of 81.3% (148/182), specificity of 66.7% (16/24), and positive predictive value of 94.9% (148/156). When the data were stratified according to pathological subtypes, MDCT was observed to have a sensitivity of 86.9% (133/153) and specificity of 61.5% (8/13) in clear cell RCC, sensitivity of 38.5% (5/13) and specificity of 100% (1/1) in papillary RCC, and sensitivity of 44.4% (4/7) and specificity of 66.7% (6/9) in chromophobe RCC. A low or high-attenuation rim around the tumor in the cortico-medullary or nephrographic-to-excretory phase indicates a PC of RCC, though the accuracy is not satisfactory even with 64- or 320-detector MDCT.

Pancreatic metastasis of renal cell carcinoma: multidetector CT findings

2008 ◽  
Vol 34 (3) ◽  
pp. 385-389 ◽  
Author(s):  
Sandra Mechó ◽  
Sergi Quiroga ◽  
Hug Cuéllar ◽  
Carmen Sebastià
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Multidetector Ct ◽  
Pancreatic Metastasis ◽  
Ct Findings

scholarly journals Metastatic renal cell carcinoma of unknown primary site. Clinical follow-up

2020 ◽  
Vol 22 (3) ◽  
pp. 149-153
Author(s):  
N. A. Ognerubov ◽  
T. S. Antipova ◽  
G. E. Gumareva
Keyword(s):  
Computed Tomography ◽  
Renal Cell Carcinoma ◽  
Adrenal Gland ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Cell Cancer ◽  
Primary Site ◽  
The Right

Renal cell cancer metastases without evidence of a primary tumor are extremely rare. These variants are usually showed as a spontaneous description of single clinical cases. Aim.This contribution is a clinical follow-up of synchronous renal cell cancer metastases of unknown primary site. Results.A 52-year-old patient U. with a history of increased blood pressure, up to 170/100 mmHg for the last 5 years, who had undergone many instrumental examinations, including ultrasound examination, because of this disease. The computed tomography of the abdomen showed a 4975 mm heterogeneous tumor in the right adrenal gland in October 2017. The combined positron emission and X-ray computed tomography showed a 795441 mm mass in the right adrenal gland, associated with elevated fluorodeoxyglucose metabolic activity SUVmax 7.25. Focal accumulation of the radiopharmaceutical SUVmax 4.31 in a 171124 mm mass was detected in the space of bifurcation in the mediastinum. The lytic lesion (1015 mm) was found in right superior L3 articular process. The patient underwent retroperitoneoscopic adrenalectomy and thoracoscopic removal of mediastinal tumor in November 2017 because of the oligometastatic nature of the process. The histological study identified clear-cell carcinoma with areas of papillary structure in the right adrenal gland. The immunohistochemical study showed carcinoma cells intensively expressing CD10, and some other cells RCC. The immune phenotype of the tumor was identified as clear-cell renal cell carcinoma. The immunohistological and immunohistochemical analysis reviled the metastases of the same variant of renal cell carcinoma in one of 9 lymph nodes. The patient was treated with pazopanib. The primary renal tumor was not detected during the dynamic observation, including the application of annual combined positron emission and X-ray computed tomography. The patient is alive without disease progression with a follow-up of 32 months. Conclusion.Metastases of clear-cell renal cell carcinoma, including adrenal gland, without evidence of a primary site are extremely rare. The main method of treatment is a combination of surgery and targeted therapy, providing long-term local control of the course of the disease.

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